Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
1.
J BUON ; 16(3): 454-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22006749

RESUMO

PURPOSE: To evaluate the identification rate and the false-negative (FN) rate of sentinel lymph node biopsy (SLNB) using preoperative axillary ultrasound (AU) in patients with clinically negative and positive axilla and to prove that SLNB could also be performed in clinically axillary positive patients. METHODS: Three hundred and fifty seven consecutive T1-2 invasive breast cancer patients with clinically negative or positive axilla were enrolled in our Institution between 2006 and 2011. All patients had preoperative AU, and underwent SLNB followed by breast conserving surgery or mastectomy with level 1, 2 axillary dissection. SLNB was performed using 5 mL of 1% methylene blue. The identification (ID) rate and the FN rate of SLNB were calculated for patients with clinically negative and positive axilla, and for patients with negative AU. RESULTS: Two hundred thirty two patients (65%) were clinically axillary-negative and 125 (35%) were clinically axillary-positive. The ID rates of SLNB were 91 and 89% and the FN rates were 7 and 9%, respectively, in patients with clinically negative and positive axilla. The ID rate of SLNB increased to 94% and the FN rate decreased to 4% after the exclusion of 85 patients (24%) with metastatic lymph nodes on AU. CONCLUSION: SLNB can be safely applied to T1 tumors regardless of the clinical status of the axilla. Use of AU before SLNB significantly increases the ID rate and decreases the FN rate of SLNB in clinically axillary negative as well as in positive patients.


Assuntos
Axila/diagnóstico por imagem , Neoplasias da Mama/patologia , Biópsia de Linfonodo Sentinela/métodos , Adulto , Idoso , Reações Falso-Negativas , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Seleção de Pacientes , Ultrassonografia
2.
J Eur Acad Dermatol Venereol ; 24(1): 7-12, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19627408

RESUMO

In this review, we summarized the general characteristics of pilonidal sinus disease and details of rhomboid flap (RF) technique used in its treatment, and discussed the results of RF methods and its comparison with other techniques, principally with flap technique available in the literature. When performed studies are examined, RF technique has come into prominence nowadays with low recurrence and infection rates, and with a comfortable surgical technique. Recently, it has been anticipated that with the modification of this technique, the recurrence rate would be lower.


Assuntos
Seio Pilonidal/cirurgia , Região Sacrococcígea/cirurgia , Sacro/cirurgia , Retalhos Cirúrgicos , Humanos , Cuidados Pós-Operatórios , Recidiva
3.
Colorectal Dis ; 10(9): 945-8, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18462233

RESUMO

OBJECTIVE: To investigate the results of rhomboid excision and the Limberg flap procedure to treat pilonidal sinus disease. METHOD: The records of 411 patients with pilonidal sinus disease, who underwent rhomboid excision and Limberg flap procedure, were analysed. All sinus tracks were resected en bloc, and a Limberg flap was prepared from left or right gluteal region. A suction drain was routinely used. RESULTS: The mean follow-up period was 109.2 +/- 4.5 months (range: 12-183 months). Recurrence occurred in 12 (2.91%) patients who were all male. In 42 (10.21%) patients, anaesthesia or hypoaesthesia of the upper portion of the flap occurred; this was temporary in 25 patients. Twelve (2.91%) patients developed a seroma and 15 (3.64%) a wound infection. The average hospital stay was 3.2 days (range: 1-10 days), and the average time of return to work was 12.4 days (range: 7-18 days). The average time to walk without pain was 13.4 days (range: 10-28 days) and the average time to sitting on the toilet without pain was 16.1 days (range: 12-28 days). CONCLUSION: The Limberg flap procedure is effective and has a low complication rate, short time for returning to normal activity and short hospitalization.


Assuntos
Seio Pilonidal/cirurgia , Retalhos Cirúrgicos , Adolescente , Adulto , Drenagem , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
4.
Hernia ; 10(4): 326-30, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16770517

RESUMO

Most of the papers published on spigelian hernia are either case reports or small retrospective series. In this prospective multicenter study, we aimed to outline the specific features of spigelian hernias and patients' characteristics more clearly. Surgeons enrolled patients to be entered into the database as they diagnosed and treated the hernias at will. The baseline and surgical outcome parameters were noted in each patient. A painful mass was the main presenting complaint in half of 34 patients. Accurate preoperative diagnosis was possible in 31 patients. Open intraperitoneal mesh repair was the preferred technique. The mean hospital stay and time until return to normal daily activities were 4.1 and 15.6 days. Although a rare condition, diagnosis of a spigelian hernia is not difficult once remembered. Its surgical repair seems to cause few complications and is very well tolerated by the patient.


Assuntos
Hérnia Ventral/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hérnia Ventral/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
5.
Eur J Surg Oncol ; 42(1): 87-93, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26527545

RESUMO

BACKGROUND: Selection of nodules for surgery diagnosed as Bethesda category III [atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) category] is very important. We aimed at to define the predictive factors for malignancy and factors associated with triage to surgery. METHODS: The records of all patients with nodules who underwent fine needle aspiration biopsy (FNAB) and classified by Bethesda reporting system as AUS/FLUS between 2011 and 2015 at our institution were reviewed. Univariate and multivariate analysis were performed to select independent factors associated with thyroid cancer and with triage to surgery. Using independent risk factors for malignancy predictive index categories were created. RESULTS: Of the 485 patients who were classified as AUS/FLUS on initial FNAB, 153 underwent surgery with the associated malignancy rate of 22.8%. The malignancy rates for AUS/FLUS patients with and without repeat FNAB were 37.5% and 16.2%, respectively. Multivariate logistic regression analysis revealed that solid structure, microcalcification, hypoechogenicity, increased vascularization, and irregular margin were found to be significant and independent risk factors associated for malignancy, and solid structure, microcalcifications, increased nodule size (≥2 cm) and younger patient age (<65 years) were associated with triage to surgery. CONCLUSIONS: Our findings showed that using predictive factors for malignancy in AUS/FLUS category as risk indices, an important proportion of patients (35%) who had nodules without any risk factors could be spared unnecessary surgery. We suggest that predictive indices should be considered for selection of the patients to triage to surgery.


Assuntos
Adenocarcinoma Folicular/patologia , Transformação Celular Neoplásica/patologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Tireoidectomia/métodos , Triagem/métodos , Adenocarcinoma Folicular/classificação , Adenocarcinoma Folicular/cirurgia , Adulto , Idoso , Biópsia por Agulha Fina/métodos , Estudos de Coortes , Intervalos de Confiança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Razão de Chances , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Neoplasias da Glândula Tireoide/classificação , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/classificação , Resultado do Tratamento , Conduta Expectante/métodos
6.
J Laparoendosc Adv Surg Tech A ; 11(4): 207-11, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11569509

RESUMO

BACKGROUND AND PURPOSE: The use of laparoscopy for the treatment of various surgical diseases has been well described, and recently, it has gained popularity in the evaluation of abdominal trauma patients. The value of diagnostic laparoscopy (DL) in avoiding unnecessary laparotomies and its effects on hospital costs was evaluated in a prospective clinical trial. PATIENTS AND METHODS: In a 48-month period, 99 hemodynamically stable abdominal trauma patients (28 blunt and 71 penetrating injuries) among 428 patients admitted with abdominal trauma in whom the decision for surgical exploration was made were accepted for the study and underwent DL prior to laparotomy. RESULTS: The DL was negative in 60.7% of the patients with blunt abdominal trauma (BAT) and in 62.0% of the patients with penetrating abdominal trauma (PAT). Laparoscopy-positive patients (Group 1) underwent immediate laparotomy, whereas on DL-negative patients (Group 2), no laparotomies were performed. Hospitalization times and hospital costs of the two groups were recorded and compared. The difference between the hospitalization times of Group 1 and Group 2 was statistically significant (P < 0.001). The use of DL reduced the rate of unnecessary laparotomies from 60.7% to 0 in BAT and from 78.9% to 16.9% in PAT. The mean hospitalization time was 2.75 +/- 1.20 days in patients with negative DL, whereas it was 7.4 +/- 2.20 days and 5.2 +/- 1.42 days in DL-positive patients undergoing a therapeutic and nontherapeutic laparotomy, respectively. When the hospital costs of the Group 1 patients were compared with those of Group 2 patients, there was a 4.07-fold increase in patients undergoing therapeutic laparotomy and a 1.78-fold increase in patients undergoing nontherapeutic laparotomy. CONCLUSION: Diagnostic laparoscopy might be used in selected patients to exclude significant intra-abdominal injuries.


Assuntos
Traumatismos Abdominais/diagnóstico , Laparoscopia/economia , Laparotomia/economia , Ferimentos não Penetrantes/diagnóstico , Ferimentos Penetrantes/diagnóstico , Traumatismos Abdominais/economia , Adolescente , Adulto , Custos e Análise de Custo , Feminino , Humanos , Tempo de Internação/economia , Masculino , Estudos Prospectivos , Ferimentos não Penetrantes/economia , Ferimentos Penetrantes/economia
7.
Acta Radiol ; 38(3): 428-30, 1997 May.
Artigo em Inglês | MEDLINE | ID: mdl-9191435

RESUMO

Agenesis of the right lobe of the liver is an extremely rare congenital anomaly, usually accompanied by additional anomalies such as a retrohepatically or suprahepatically located gallbladder. In this report we present a new case of agenesis of the right lobe of the liver with the Chiliaditi syndrome and a subdiaphragmatic hydatid cyst, diagnosed by CT and CT-cholangiography.


Assuntos
Fígado/anormalidades , Colangiografia , Colecistografia , Colo/anormalidades , Colo/diagnóstico por imagem , Diafragma/diagnóstico por imagem , Diafragma/parasitologia , Equinococose/diagnóstico por imagem , Equinococose/patologia , Feminino , Vesícula Biliar/anormalidades , Humanos , Fígado/diagnóstico por imagem , Pessoa de Meia-Idade , Síndrome , Tomografia Computadorizada por Raios X
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA