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2.
BMJ ; 367: l5830, 2019 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-31585943
3.
Cochrane Database Syst Rev ; 9: CD005360, 2019 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-31557310

RESUMO

BACKGROUND: Surgery has been used as part of breast cancer treatment for centuries; however any surgical procedure has the potential risk of infection. Infection rates for surgical treatment of breast cancer are documented at between 3% and 15%, higher than average for a clean surgical procedure. Pre- and perioperative antibiotics have been found to be useful in lowering infection rates in other surgical groups, yet there is no consensus on the use of prophylactic antibiotics for breast cancer surgery. This is an update of a Cochrane Review first published in 2005 and last updated in 2014. OBJECTIVES: To determine the effects of prophylactic (pre- or perioperative) antibiotics on the incidence of surgical site infection (SSI) after breast cancer surgery. SEARCH METHODS: For this fourth update, in August 2018 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase; and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials of pre- and perioperative antibiotics for patients undergoing surgery for breast cancer. Primary outcomes were rates of surgical site infection (SSI) and adverse reactions. DATA COLLECTION AND ANALYSIS: Three review authors independently examined the title and abstracts of all studies identified by the search strategy, then assessed study quality and extracted data from those that met the inclusion criteria. We contacted study authors to obtain missing information. We evaluated the certainty of evidence using the GRADE approach. We used standard methodological procedures expected by Cochrane. MAIN RESULTS: A total of 11 randomised controlled trials (2867 participants) were included in the review. No new studies were identified in this update. All studies included breast cancer patients and were based in the hospital setting. Ten studies evaluated preoperative antibiotic compared with no antibiotic or placebo. One study evaluated perioperative antibiotic compared with placebo or no antibiotic. Pooling of the results demonstrated that prophylactic antibiotics administered preoperatively probably reduce the incidence of SSI for patients undergoing breast cancer surgery without reconstruction (pooled risk ratio (RR) 0.67, 95% confidence interval (CI) 0.53 to 0.85; moderate certainty evidence). Anticipated absolute effects were calculated for the outcome incidence of SSI; 105 per 1000 for the none or placebo group and 71 per 1000 (95% CI 56 to 89) for the preoperative antibiotic prophylaxis group. Analysis of the single study comparing perioperative antibiotic with no antibiotic was inconclusive for incidence of SSI (RR 0.11, 95% CI 0.01 to 1.95; very low certainty evidence). No studies presented separate data for patients who underwent reconstructive surgery at the time of removal of the breast tumour.Secondary outcomes were not consistently included in the studies investigating preoperative antibiotic prophylaxis. It is very uncertain whether there is a difference in incidence of adverse events between the treatment and no treatment or placebo groups (10 studies, 2818 participants); very low certainty evidence downgraded one level for serious risk of bias, one level for serious inconsistency and one level for serious imprecision. It is unclear whether there is a difference in time to onset of infection between the treatment and no treatment or placebo groups (4 studies, 1450 participants); low certainty evidence downgraded one level for serious risk of bias and one level for serious inconsistency. It is unclear whether there is a difference in rates of readmission to hospital between the treatment and placebo groups (3 studies, 784 participants); low certainty evidence downgraded one level for serious inconsistency and one level for serious risk of bias. It is unclear whether there is a difference in cost of care between the treatment and no treatment or placebo groups (2 studies, 510 participants); low certainty evidence downgraded one level for serious risk of bias and one level for serious inconsistency. No analysable secondary outcome data were reported for the single study evaluating perioperative antibiotics. AUTHORS' CONCLUSIONS: Prophylactic antibiotics administered preoperatively probably reduce the risk of SSI in patients undergoing surgery for breast cancer. However, it is very uncertain whether there is an effect on incidence of adverse events. Furthermore, the effects on time to onset of infection, readmission to hospital and cost of care remain unclear. Further studies are required to establish the best protocols for clinical practice.


Assuntos
Antibioticoprofilaxia , Neoplasias da Mama/cirurgia , Infecção da Ferida Cirúrgica/prevenção & controle , Feminino , Humanos , Mastectomia , Cuidados Pré-Operatórios/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Cicatrização
4.
Khirurgiia (Mosk) ; (8. Vyp. 2): 60-64, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31502595

RESUMO

Mechanical bowel preparation used to be a standard procedure for a long time. Nowadays routine use of MBP seems to be debatable thus alternative approaches, e.g. avoiding any bowel preparation completely or using of MBP with oral antibiotics are considered. Data on performing different kinds of bowel preparation is reviewed in this article.


Assuntos
Antibacterianos/administração & dosagem , Catárticos/administração & dosagem , Colectomia , Cuidados Pré-Operatórios/métodos , Protectomia , Administração Oral , Procedimentos Cirúrgicos Eletivos , Humanos
5.
Anticancer Res ; 39(9): 5123-5133, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519624

RESUMO

BACKGROUND/AIM: We investigated the role of esophagectomy after clinical complete response (cCR) to chemoradiotherapy for esophageal squamous cell carcinoma (ESCC). PATIENTS AND METHODS: Patients with resectable cT3-T4a/anyN/M0 or anyT/N+/M0 thoracic ESCC received two cycles of induction chemotherapy and then chemoradiotherapy (50.4 Gy/28 fractions). Patients with cCR were randomized to surgery or observation. RESULTS: Among 86 patients, 38 (44.2%) achieved cCR after chemoradiotherapy; 37 were randomized to surgery (n=19) or observation (n=18). Although there were trends of better disease-free survival (DFS) toward the surgery arm in the intent-to-treat analysis (2-year DFS, 66.7% vs. 42.7%; p=0.262) or as-treated analysis (66.7% vs. 50.2%; p=0.273), overall survival was not different between the two arms in the intent-to-treat (HR=1.48; p=0.560) or as-treated analysis (HR=1.09; p=0.903). Among the 11 patients having recurrence during observation, 8 underwent surgery (n=7) or endoscopic dissection (n=1). CONCLUSION: Close observation with salvage surgery might be a reasonable option in resectable ESCC patients achieving cCR after chemoradiation.


Assuntos
Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/terapia , Esofagectomia , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/métodos , Terapia Combinada , Progressão da Doença , Neoplasias Esofágicas/patologia , Esofagectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Prognóstico , Resultado do Tratamento , Adulto Jovem
6.
Magy Seb ; 72(3): 83-97, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31544487

RESUMO

Introduction: Thymectomy became an important part of the treatment of myasthenia gravis, since Alfred Blalock reported about his first surgery 80 years ago. Despite of several different surgical techniques already accepted abroad, sternal approach was the almost exclusive exposure for thymectomy in Hungary till 2006. In this publication, we analyze the direct surgical consequences and complications of this method. Methods: At the Surgical Department of Budai MÁV Hospital, 1002 transsternal thymectomies were performed during 34 years on patients suffering from myasthenia gravis. Surgeries were performed for neurological indications, following careful medical investigations, involving specialists in neurology and internal medicine. In cases associated with thymoma, surgery was indicated for two reasons: removal of the thymus and the tumor at the same time. Neurological indications, patient preparation, perioperative treatment and surgical technique have considerably changed during these 34 years. We interpret the results according to the two eras based on the most frequently applied surgical techniques (simple and extended thymectomy); we publish the data separately of the patients with thymoma and those who underwent repeated surgery, focusing basically on breath-related complications. Results: The patients' age was 32 years on the average (8-73 years). Women/men ratio: 3.5:1. Myasthenia gravis was associated with thymoma in 12.7% of the patients. Repeated thymectomy was necessary in case of 11 patients; further two patients required repeated sternotomy after cardiac surgery. Respiratory failure occurred in 21,3% out of 525 myasthenic patients operated in the first 19-year-old era, emergency re-intubation and tracheostomy happened in 12,8% and in 11,2% as well. In the second 15-year-old period postoperative respiratory failure occurred in 12,7% with emergency re-intubation in 7,1% and tracheostomy only in 1,2% out of 338 myasthenic patients. Respiratory failure occurred in 19.1% out of 126 patients operated for thymoma; re-intubation was necessary in 12.8% of the cases and tracheostomy was performed in 20.6% of the patients. Respiratory failure occurred in 13 patients, who underwent repeated surgery (46.1%); the ratio of re-intubation was 15.4% and that of tracheostomies 46.1%. Serious surgical complications were infrequent also in the entire group of patients: 2 patients required repeated surgery due to sternal bleeding; one more patient underwent repeated surgery due to rupture of the drainage tube, 4 cases of mediastinitis in the first group, two cases of heart injury and one case of sternal disruption occurred in the second period. The overall mortality was 1.4%: 1.3% in the first period, 0.3% in the second period, 4% in the thymoma group and 7.7% after repeated surgeries. Conclusions: In a historical overview, the ratio of serious respiratory and airway complications and the mortality after transsternal thymectomies has considerably decreased, but the postoperative respiratory failure and the surgical risk of transsecting the sternum still pose a real risk.


Assuntos
Miastenia Gravis/cirurgia , Esterno/cirurgia , Timectomia/métodos , Timoma/cirurgia , Neoplasias do Timo/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miastenia Gravis/patologia , Cuidados Pré-Operatórios , Timoma/patologia , Neoplasias do Timo/patologia , Resultado do Tratamento
10.
Cancer Radiother ; 23(6-7): 716-719, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31421997

RESUMO

Management of resectable esophageal carcinoma is based on a multimodal treatment associating neo-adjuvant chemoradiation before surgery. This therapeutic sequence allows a disease-free survival rate at 2 years around 45% but remains associated with a high post-operative morbidity. In case of definitive chemoradiotherapy, the dose delivered to the macroscopic disease is a controversial topic since decades and the prognosis of patients treated in this setting at the dose of 50Gy remains poor. This article proposes a review of the main published data and the ongoing studies related to the management of these patients.


Assuntos
Carcinoma/terapia , Quimiorradioterapia Adjuvante/métodos , Neoplasias Esofágicas/terapia , Terapia Neoadjuvante , Humanos , Cuidados Pré-Operatórios/métodos , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/métodos
11.
Anaesthesia ; 74(9): 1147-1152, Ago., 28, 2019. ilus, tab
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1015569

RESUMO

We examined the potential for voice sounds to predict a difficult airway as compared with prediction by the modified Mallampati test. A total of 453 patients scheduled for elective surgery under general anaesthesia with tracheal intubation were studied. Five phonemes were recorded and their formants analysed. Difficult laryngoscopy was defined as the Cormack-Lehane grade 3 or 4. Univariate and multivariate logistic regression were used to examine the association between some variables (mouth opening, sternomental distance, modified Mallampati and formants) and difficult laryngoscopy. Difficult laryngoscopy was reported in 29/453 (6.4%) patients. Among five regression models evaluated, the model achieving better performance to predict difficult laryngoscopy, after a variable selection criteria (stepwise, multivariate) and included a modified Mallampati classification (OR 2.920; 95%CI 1.992-4.279; p < 0.001), first formant of /i/(iF1) (OR 1.003; 95%CI 1.002-1.04; p < 0.001), and second formant of /i/(iF2) (OR 0.998; 95%CI 0.997-0.998; p < 0.001). The receiver operating curve for a regression model that included both formants and Mallampati showed an area under curve of 0.918, higher than formants alone (area under curve 0.761) and modified Mallampati alone (area under curve 0.874). Voice presented a significant association with difficult laryngoscopy during general anaesthesia showing a 76.1% probability of correctly classifying a randomly selected patient.(AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Intubação Intratraqueal , Anestesia
12.
Rev Col Bras Cir ; 46(3): e20192175, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389524

RESUMO

OBJECTIVE: to evaluate the feasibility of abbreviated fasting in oncologic colorectal surgeries, as well as the impact on the surgical outcome of the patients. METHODS: prospective randomized comparative study with patients undergoing elective colorectal cancer surgeries from May to September 2017. Patients were randomized electronically into two groups according to the preoperative fast to be adopted: conventional or abbreviated. RESULTS: of the 33 patients included, 15 followed the abbreviated fasting protocol and 18 the conventional fasting. Both groups had comparable profiles. No patient underwent mechanical preparation of the colon. In 69.7% of the cases, surgery involved low rectal dissection. The procedures were equivalent in relation to intraoperative variables and severe complications. The time to achieve complete oral intake was shorter for abbreviated fasting (10 versus 16 days, p=0.001), as well as the length of inhospital stay (2 versus 4 days, p=0.009). Hospital costs were lower in the abbreviated fasting (331 versus 682 reais, p<0.001). The univariable analysis revealed a correlation between complete oral intake and abbreviated fasting [HR 0.29 (IC95%: 0.12-0.68] and abdominal distension [HR 0.12 (IC95% 0.01-0.94)]. After multivariable analysis, abbreviated fasting presented a lower time for complete oral intake [HR 0.39 (IC95%: 0.16-0.92]. CONCLUSION: the abbreviated preoperative fasting favors the metabolic-nutritional recovery, reducing the time for complete oral intake. The implementation of the abbreviation protocol reduces hospital admission costs.


Assuntos
Neoplasias Colorretais/cirurgia , Procedimentos Cirúrgicos Eletivos/economia , Jejum , Cuidados Pré-Operatórios/métodos , Idoso , Neoplasias Colorretais/economia , Método Duplo-Cego , Feminino , Custos Hospitalares , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos
13.
Medicine (Baltimore) ; 98(33): e16843, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415409

RESUMO

BACKGROUND: The aim of this study was, from the Chinese healthcare perspective, to assess the cost-effectiveness of positron-emission tomography-computed tomography (PET-CT) with F-fluorodeoxyglucose (F-FDG) in preoperation staging for nonsmall-cell lung cancer (NSCLC) with resected monometastatic disease based on a retrospective study. This study was conducted from January 2017 to February 2019 at an academic hospital. METHODS: A Markov model and 3 decision-tree models were designed to calculate the long-term medical costs, outcomes, and incremental cost-effectiveness ratios (ICERs) of the 2 diagnostic strategies (PET-CT and conventional CT). Model robustness was assessed in sensitivity analyses. RESULTS: For the base-case analysis, preoperative PET-CT evaluation for NSCLC with resected monometastatic disease provided an additional 1.475, 2.129, and 2.412 life-years (LYs), in the time horizon of 10-, 20-, and 30-year, respectively, and the ICERs for the PET-CT group compared with the conventional CT group were $1153, $1393, and $1430 per LY, separately. The acceptability curves demonstrated that when the willingness-to-pay (WTP) thresholds ranged from $500 to $3000/LY, the probability of cost-effectiveness changed varied dramatically, and at WTP > $3000, the probability that the PET-CT group achieved cost-effectiveness was 100%. Sensitivity analyses suggested that the models we designed were robust. CONCLUSION: Compared with conventional CT scan, preoperative F-FDG PET-CT evaluation for patients with resected monometastatic NSCLC is cost-effective from the Chinese healthcare perspective. Preoperative F-FDG PET-CT evaluation should be popularized for patients with resected monometastatic NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/economia , China , Análise Custo-Benefício , Árvores de Decisões , Humanos , Linfonodos/diagnóstico por imagem , Cadeias de Markov , Estadiamento de Neoplasias/instrumentação , Cuidados Pré-Operatórios/economia , Cuidados Pré-Operatórios/métodos , Estudos Retrospectivos
15.
Arq Bras Cir Dig ; 32(2): e1439, 2019 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31460599

RESUMO

BACKGROUND: Abdominal disorders can alter respiratory function and increase the morbidity and mortality of patients with chronic obstructive pulmonary disease. AIM: To improve the physiotherapeutic and muscular capacity in chronic obstructive pulmonary muscular inspiration in the preoperative preparation in abdominal surgeries. METHOD: Retrospective and documentary study using SINPE © , clinical database software of patients with chronic obstructive pulmonary disease and candidates to abdominal operation. The sample consisted of 100 men aged 55-70 years, all with chronic obstructive pulmonary disease who underwent preoperative physiotherapeutic treatment. They were divided into two groups of 50 individuals (group A and group B). In group A the patients were treated with modern mobility techniques for bronchial clearance and the strengthening of the respiratory muscles was performed with IMT ® Threshold. In group B the treatment performed for bronchial obstruction was with classic maneuvers and for the strengthening of the respiratory muscles for flow incentive was used Respiron ® . RESULTS: Both groups obtained improvement in the values ​​of the PiMáx after the different treatments. Group A obtained greater change in the intervals and a more significant increase of the values of the PiMax in relation to the average pre and post-treatment. However, when analyzing the variance and the standard deviation of the samples, group B presented the best results showing more homogeneity. CONCLUSIONS: The modern and traditional bronchial clearance techniques associated with inspiratory muscle training were equally effective in gaining inspiratory muscle strength with increased Pmax. In this way, the two can be used in the preoperative preparation of patients with chronic obstructive pulmonary disease and referred to abdominal operations.


Assuntos
Exercícios Respiratórios/métodos , Procedimentos Cirúrgicos do Sistema Digestório , Cuidados Pré-Operatórios/métodos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Músculos Respiratórios/fisiopatologia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/reabilitação , Testes de Função Respiratória , Estudos Retrospectivos , Software , Espirometria
16.
Anticancer Res ; 39(8): 4249-4252, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366513

RESUMO

BACKGROUND/AIM: Video-assisted thoracic surgery (VATS) for ipsilateral reoperations is challenging because of the potential for pleural adhesions. Insertion of the initial port can lead to lung injury because of the blinded intrathoracic area. We assessed the usefulness of ultrasonography before VATS to reduce the incidence of lung injury at the time of the initial port insertion during secondary ipsilateral VATS. PATIENTS AND METHODS: Thirty-three patients who underwent repeat VATS for ipsilateral pulmonary lesions were included. All patients underwent preoperative ultrasonography to assess the possible presence of pleural adhesions using the lung sliding sign. RESULTS: Seven adhesions were found at the VATS ports. Two of these adhesions were not evaluated as pleural adhesions using ultrasonography; however, they were loose. All initial ports were inserted without lung injury. There were no major complications. CONCLUSION: Preoperative detection of pleural adhesions using ultrasonography can determine the best initial port for secondary ipsilateral VATS.


Assuntos
Doenças Pleurais/cirurgia , Cirurgia Torácica Vídeoassistida , Cirurgia Torácica/métodos , Ultrassonografia , Adulto , Idoso , Feminino , Humanos , Pulmão/fisiopatologia , Pulmão/cirurgia , Lesão Pulmonar/fisiopatologia , Lesão Pulmonar/cirurgia , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/fisiopatologia , Cuidados Pré-Operatórios , Toracotomia , Aderências Teciduais/fisiopatologia
17.
Zhonghua Zhong Liu Za Zhi ; 41(8): 604-609, 2019 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-31434452

RESUMO

Objective: To evaluate preoperative nutritional status and inflammatory status by Nutritional Risk Screening-2002 (NRS-2002) and hematologic inflammatory markers in patients with thoracic esophageal squamous cell carcinoma (ESCC), and to explore their effects on long-term survival prognosis. Methods: A total of 113 patients with thoracic ESCC treated by radical resection were grouped for further analysis according to preoperative NRS-2002 score, systemic inflammation score (SIS) and the combination of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (CNP) score. The progression free survival (PFS) and overall survival (OS) between groups were compared. Multivariate Cox regression analysis was used to determine the independent prognostic factors of patients with thoracic esophageal squamous cell carcinoma, and the interaction analysis of statistically significant factors was carried out. Results: The median PFS was 21 months for all the patients. The 1-year, 3-year and 5-year PFS rates were 69.0%, 25.7% and 23.1%, respectively. Correspondingly, the median OS was 36 months, and the 1-year, 3-year and 5-year OS rates were 95.6%, 46.2% and 29.2%, respectively. Cox univariate analysis showed that T stage, N stage, TNM stage, SIS, CNP score and NRS-2002 score were significantly associated with PFS and OS (all P<0.05), and sex was associated with PFS (P=0.032) in patients with thoracic ESCC. Furthermore, cox multivariate analysis showed that TNM stage (HR=1.570, P=0.039), NRS-2002 score (HR=2.706, P<0.001) and CNP score (HR=1.463, P=0.011) were independent prognosis factors of PFS in patients with thoracic ESCC. In cox model interaction analysis, there was a positive interaction between NRS-2002 score and CNP score (RR=2.789, P<0.001). Conclusion: Preoperative NRS-2002 score combined with CNP score are risk factors for prognosis of patients with thoracic ESCC, which can be used as prognostic indicators.


Assuntos
Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago/cirurgia , Neoplasias Torácicas/cirurgia , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Neutrófilos , Estado Nutricional , Contagem de Plaquetas , Cuidados Pré-Operatórios , Prognóstico , Medição de Risco
18.
Zhonghua Zhong Liu Za Zhi ; 41(8): 610-614, 2019 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-31434453

RESUMO

Objective: To evaluate the value of preoperative diagnosis of extramural vascular invasion (EMVI) of rectal cancer with 3.0T high-resolution magnetic resonance imaging (MRI) and the MRI-related factors of EMVI in rectal cancer. Methods: The clinical and imaging data of 40 patients with rectal cancer were retrospectively analyzed. The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic efficacy of preoperative diagnosis of EMVI of rectal cancer by high-resolution MRI, and to analyze the relationship between the EMVI and clinical and MRI features. Results: Of the 40 patients, 19 cases were diagnosed as positive EMVI and 21 were negative by MRI. Pathological diagnosis of EMVI was positive in 10 cases and negative in 30 cases. The sensitivity, specificity and accuracy of MRI in the diagnosis of EMVI were 100%, 70.0% and 77.5%, respectively. Preoperative MRI and postoperative pathology were moderately consistent in the diagnosis of EMVI in rectal cancer (Kappa=0.538, P<0.001). Pathological EMVI positivity were related to tumor size under MRI examination (P=0.028), degree of differentiation (P<0.001), depth of invasion (P=0.002), lymph node metastasis (P=0.001), liver metastasis (P=0.011), tumor apparent diffusion coefficient (ADC) value (P=0.010) and exponential apparent diffusion coefficient (eADC) value (P=0.003). It also related to extramural nerve invasion by pathological examination (P=0.005). Conclusion: According to the EMVI imaging score of rectal cancer, preoperative MRI has a high value in the diagnosis of EMVI of rectal cancer.


Assuntos
Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Invasividade Neoplásica , Cuidados Pré-Operatórios , Estudos Retrospectivos , Sensibilidade e Especificidade
19.
BMC Ophthalmol ; 19(1): 169, 2019 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-31376834

RESUMO

BACKGROUND: Accurate alignment of toric intraocular lens (TIOL) to steep corneal astigmatic axis is important to achieve effective postoperative results. The authors compare the accuracy of astigmatism correction using automated and manual marking in TIOL implantation during cataract surgery. METHODS: One hundred thirty-two eyes with nuclear density from Grade 2 to 4 were randomly subdivided into 2 groups (automated and manual marking). All patients underwent manual marking and the steep axis was compared to SensoMotoric Instruments (SMI). After phacoemulsification, 62 patients underwent toric IOL implantation using the SMI and 70 patients underwent toric IOL implantation using manual marking. Intraoperative measurement was the steep axis difference. Clinical measurements included preoperative and postoperative best corrected visual acuity (BCVA), and TIOL axis. RESULTS: The intraoperative steep axis difference between SMI and manual marking was 7.86 ± 6.4 degrees. The difference between the preoperative steep axis and the postoperative TIOL axis using SMI (3.63 ± 1.12 degrees) was significantly lower than that using manual marking (8.29 ± 2.23 degrees) (P < 0.05). CONCLUSIONS: The steep axis measurements may be different when using SMI vs. manual marking. The SMI is more accurate than manual marking for TIOL implantation during cataract surgery. TRIAL REGISTRATION: Current Controlled Trials ISRCTN12294725 , Retrospectively registered, on 20 July 2018.


Assuntos
Automação/métodos , Catarata/fisiopatologia , Lentes Intraoculares , Cuidados Pré-Operatórios/métodos , Refração Ocular/fisiologia , Acuidade Visual , Biometria/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Desenho de Prótese
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