ABSTRACT
ABSTRACT Introduction and Objective Radical cystectomy (RC) with pelvic lymph node dissection is the standard treatment for muscle invasive bladder cancer and the oncologic outcomes following it are directly related to disease pathology and surgical technique. Therefore, we sought to analyze these features in a cohort from a Brazilian tertiary oncologic center and try to identify those who could negatively impact on the disease control. Patients and Methods We identified 128 patients submitted to radical cystectomy, for bladder cancer treatment, from January 2009 to July 2012 in one oncology tertiary referral public center (Mario Penna Institute, Belo Horizonte, Brazil). We retrospectively analyzed the findings obtained from their pathologic report and assessed the complications within 30 days of surgery. Results We showed similar pathologic and surgical findings compared to other large series from the literature, however our patients presented with a slightly higher rate of pT4 disease. Positive surgical margins were found in 2/128 patients (1.5%). The medium number of lymph nodes dissected were 15. Major complications (Clavien 3 to 5) within 30 days of cystectomy occurred in 33/128 (25.7%) patients. Conclusions In the management of invasive bladder cancer, efforts should focus on proper disease diagnosis and staging, and, thereafter, correct treatment based on pathologic findings. Furthermore, extended LND should be performed in all patients with RC indication. A critical analysis of our complications in a future study will help us to identify and modify some of the factors associated with surgical morbidity.
Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Urinary Bladder Neoplasms/surgery , Urinary Bladder Neoplasms/pathology , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/pathology , Carcinoma, Transitional Cell/surgery , Carcinoma, Transitional Cell/pathology , Cystectomy/methods , Lymph Node Excision/methods , Pelvis , Postoperative Complications , Prognosis , Time Factors , Biopsy , Urinary Bladder Neoplasms/complications , Brazil , Carcinoma, Squamous Cell/complications , Carcinoma, Transitional Cell/complications , Adenocarcinoma/surgery , Adenocarcinoma/complications , Adenocarcinoma/pathology , Cystectomy/adverse effects , Retrospective Studies , Operative Time , Lymph Node Excision/adverse effects , Lymph Nodes/surgery , Middle AgedABSTRACT
Avaliou-se a capacitação espermática in vitro de touros por meio da viabilidade espermática e indução da reação acrossômica.Utilizou-se sêmen congelado de touros da raça Gir, que após descongelado foi incubado in vitro com O ou 1 O J.tg/ml de heparinapor quatro horas, para a capacitação, adicionando-se em seguida lisofosfatidilcolina por 15 minutos, para indução da reação. acrossômica. Foram feitas lâminas para análise da viabilidade espermática (coradas com eosina/nigrosina) e reaçãoacrossômica (coradas com naftol amarelo), antes e após o período de incubação. O tratamento com heparina proporcionoumaior taxa de espermatozóides com reação acrossômica (P 0,05), sem afetar a viabilidade espermática. Observou-se diferençaentre touros quanto à viabilidade espermática e reação acrossômica antes e após a incubação com heparina +lisofosfatidilcolina (P 0,05). O touro com maior reação acrossômica apresentou menor viabilidade espermática. Conclui-se,pelos resultados, que o sêmen antes de ser usado na fecundação in vitro, ou mesmo na monta natural ou inseminação, devater avaliada a capacitação espermática in vitro por meio da análise da taxa de viabilidade espermática e da taxa de reaçãoacrossômica, por ambas apresentarem diferenças entre indivíduos.