RESUMEN
We prospectively studied the effects of the ligation of the inferior thyroid artery (ITA) on postoperative hypoparathyroidism in 48 patients who underwent functional subtotal thyroidectomy. Patients were randomized into two groups: A, with bilateral ligation of the ITA and B, without ligation of the ITA. Parathyroid function was checked preoperatively and after surgery by clinical examination and measurement of total calcium, intact PTH, urinary calcium, and AMPc. RESULTS: A significant incidence of postoperative hypocalcemia occurred: 17 percent in group A and 13 percent in B on the 4th postoperative day. Six months later, the incidence was 5 percent in Group A and 0 percent in Group B. These differences were not statistically significant between the two groups, and neither were any of the other clinical and laboratory observations. CONCLUSION: The ligation of the ITA was not an important causal factor for the occurrence of postoperative hypocalcemia after subtotal thyroidectomy
Asunto(s)
Humanos , Masculino , Femenino , Enfermedad de Graves/cirugía , Hipocalcemia/etiología , Glándulas Paratiroides/fisiopatología , Glándula Tiroides/irrigación sanguínea , Tiroidectomía/métodos , Arterias/cirugía , Calcio/sangre , Calcio/orina , AMP Cíclico/orina , Ligadura , Hormona Paratiroidea/sangre , Periodo Posoperatorio , Estudios Prospectivos , Tiroidectomía/efectos adversosRESUMEN
The charts of 58 patients with squamous-cell carcinomas of the lower lip, treated at the General Hospital of the University of Sao Paulo Medical School from January 1980 to December 1989, were retrospectively analyzed. In addition to regular demographic data, all available information was collected regarding: smoking and drinking habits; sun exposure; clinical stage; macroscopic features of the primary lesions; type of treatment; and follow-up. A meticulous pathological analysis, comprising the histologic differentiation grade, maximal tumor thickness, sun elastosis, perineural spread, vascular and muscular invasion, surgical margins, peritumoral inflammatory infiltrate, and positive lymph nodes, with or without extracapsular spread, was undertaken as well. The evaluation of the overall 5-year survival showed significant statistical differences, with prognostic implications, for the following variables: maximal tumor thickness, T-stage and positive nodes.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Neoplasias de los Labios/patología , Carcinoma de Células Escamosas/patología , Anciano de 80 o más Años , Neoplasias de los Labios/cirugía , Estudios Retrospectivos , Estudios de Seguimiento , Análisis de Supervivencia , Carcinoma de Células Escamosas/cirugía , Metástasis Linfática , PronósticoRESUMEN
De 1981 a 1988, 10 pacientes portadores de extensas lesöes tumorais em Cabeça e Pescoço foram submetidos a ressecçöes craniofaciais oncológicas, seguidos de reconstruçäo com retalhos transplantados com microcirurgia vascular. Foram executados 11 retalhos microcirúrgicos: cinco do músculo grande dorsal, três do músculo reto abdominal, um do omento maior e um paraescapular. Bons resultados foram obtidos em nove pacientes (90%) e nove retalhos (82%). Num mesmo doente, houve perda total dos dois retalhos microcirúrgicos empregados (um grande dorsal e um omento maior), provavelmente devido a uma somatória de fatores desfavoráveis. Após a apresentaçäo detalhada de um caso representativo e da análise crítica, algumas conclusöes säo delineadas em relaçäo a estas técnicas reconstrutivas