Subject(s)
Humans , Female , Aged , Hemangiosarcoma/surgery , Back Muscles/surgery , Mastectomy , Breast NeoplasmsSubject(s)
Breast Neoplasms , Mammaplasty , Humans , Female , Mastectomy , Breast Neoplasms/surgery , Mammaplasty/adverse effects , MusclesABSTRACT
INTRODUCCIÓN: Una única dosis de radioterapia intraoperatoria (IORT) en cáncer de mama precoz (EBC) puede ser una opción frente a la radioterapia externa estándar (WBRT). Sin embargo, no existe consenso sobre su uso y resultados. OBJETIVO: Analizar la morbilidad y resultados oncológicos de la IORT como monoterapia en el tratamiento del EBC. MÉTODOS: Se realiza un estudio analítico observacional unicéntrico, comparando una cohorte prospectiva IORT (2015-17) con una cohorte retrospectiva WBRT (2012-17). Los criterios de selección aplicados son: ≥ 45 años de edad, carcinoma ductal infiltrante o variantes, tamaño tumoral radiológico ≤ 3 cm, receptores estrogénicos positivos, HER2 negativo, cN0; criterios de exclusión: invasión linfovascular, multicentricidad/multifocalidad, mutaciones BRCA y tratamiento neoadyuvante. Se valoran características clínicas, tumorales, quirúrgicas, oncológicas y complicaciones. RESULTADOS: Se estudiaron 425 casos: 217 tratados con IORT y 208 con WBRT. La edad media en IORT y WBRT fue 67 ± 9,5 y 64,8 ± 9,9 años, respectivamente (p = 0,01). El riesgo ASA 3 en IORT fue 17,7%, frente a 24 casos de WBRT (p = 0,027). No hubo diferencias en resultados anatomopatológicos o estadificación. El seguimiento medio de IORT fue 24,4 ± 8 meses, frente a 50,5 ± 18 meses de WBRT (p < 0,001). No se hallaron diferencias significativas en recidiva local, metástasis o mortalidad. Las complicaciones que precisaron reintervención u hospitalización resultaron equiparables. La radiodermitis precoz grave se presentó en tres casos IORT frente a 14 casos WBRT (p = 0,01). CONCLUSIONES: La IORT como monoterapia en pacientes seleccionadas con EBC representa una opción alternativa frente a WBRT, especialmente en aquellas con edad avanzada y comorbilidades. Se asocia, además, con menos radiodermitis precoz grave
INTRODUCTION: In early breast cancer (EBC), a single dose of intraoperative radiotherapy (IORT) might be an option to standard whole breast radiotherapy (WBRT). However, there is no consensus about its use and clinical results. AIM: to analyse the morbidity and oncological outcomes of IORT as monotherapy in EBC. METHODS: A single centre observational analytic study was performed. A prospective IORT cohort (2015-17) and a retrospective WBRT cohort (2012-17) were selected following the same criteria: ≥ 45 y.o., invasive ductal carcinoma or variants, radiological tumour size ≤ 3 cm, positive oestrogenic receptors, negative HER2, cN0; exclusion criteria: lymphovascular invasion, multicentricity/multifocality, BRCA mutation and neoadjuvant therapy. Clinical, histological, surgical, oncological characteristics and complications were collected. RESULTS: A total of 425 cases were selected: 217 in IORT cohort and 208 in WBRT cohort. Average age in IORT and WBRT groups was 67±9.5 and 64.8 ± 9.9 y.o. respectively (p = 0.01). ASA 3 risk score patients were 17.7% in IORT and 24 cases in WBRT (p = 0.027). There were no differences in histological results or tumoral stage. Average follow up was 24.4 ± 8 months in IORT and 50.5 ± 18 months in WBRT (p < 0.001). No differences were detected in local recurrence, metastases or mortality. Complications that required reintervention or hospitalization were similar in both groups. A total of 3 and 14 cases developed early severe dermatitis in IORT and WBRT groups respectively (p = 0.01). CONCLUSION: IORT as monotherapy in selected patients with EBC stands for an alternative option versus WBRT. It seems especially useful in advanced-age patients with severe comorbidities. IORT associates lesser early severe dermatitis
Subject(s)
Humans , Female , Middle Aged , Aged , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Carcinoma/surgery , Carcinoma/radiotherapy , Prospective Studies , Radiotherapy, Adjuvant , Treatment Outcome , Follow-Up Studies , Risk Assessment , Early Detection of Cancer , Radiodermatitis/etiology , Neoplasm Recurrence, LocalABSTRACT
INTRODUCTION: In early breast cancer (EBC), a single dose of intraoperative radiotherapy (IORT) might be an option to standard whole breast radiotherapy (WBRT). However, there is no consensus about its use and clinical results. AIM: to analyse the morbidity and oncological outcomes of IORT as monotherapy in EBC. METHODS: A single centre observational analytic study was performed. A prospective IORT cohort (2015-17) and a retrospective WBRT cohort (2012-17) were selected following the same criteria: ≥ 45 y.o., invasive ductal carcinoma or variants, radiological tumour size ≤ 3 cm, positive oestrogenic receptors, negative HER2, cN0; exclusion criteria: lymphovascular invasion, multicentricity/multifocality, BRCA mutation and neoadjuvant therapy. Clinical, histological, surgical, oncological characteristics and complications were collected. RESULTS: A total of 425 cases were selected: 217 in IORT cohort and 208 in WBRT cohort. Average age in IORT and WBRT groups was 67±9.5 and 64.8 ± 9.9 y.o. respectively (p = 0.01). ASA 3 risk score patients were 17.7% in IORT and 24 cases in WBRT (p = 0.027). There were no differences in histological results or tumoral stage. Average follow up was 24.4 ± 8 months in IORT and 50.5 ± 18 months in WBRT (p < 0.001). No differences were detected in local recurrence, metastases or mortality. Complications that required reintervention or hospitalization were similar in both groups. A total of 3 and 14 cases developed early severe dermatitis in IORT and WBRT groups respectively (p = 0.01). CONCLUSION: IORT as monotherapy in selected patients with EBC stands for an alternative option versus WBRT. It seems especially useful in advanced-age patients with severe comorbidities. IORT associates lesser early severe dermatitis.
ABSTRACT
Objetivo. Evaluar los resultados obtenidos en la realización de cirugía conservadora del cáncer de mama mediante el uso de malla reabsorbible de poliglactina 910. Pacientes y método. Estudio prospectivo de serie de casos de pacientes intervenidas de cirugía conservadora de cáncer de mama utilizando malla de poliglactina 910 en aquellas en las que la amplitud de la resección hacía prever un resultado estético desfavorable. El estudio se llevó a cabo en un hospital de tercer nivel en el período 2010-2015. Resultados. Se intervino mediante esta técnica un total de 46 mujeres, con una media de edad de 57 años. Dos pacientes (4,3%) presentaron morbilidad postoperatoria por infección del sitio quirúrgico, requiriendo extracción de la malla en una de ellas y resolviéndose con antibioticoterapia intravenosa el otro caso. En 3 casos (6,5%) se indicó mastectomía por contacto de bordes en estudio anatomopatológico diferido. No se apreciaron dificultades en el seguimiento radiológico, ni recidivas radiológicas en el parénquima mamario, aunque sí se detectó una recidiva cutánea a nivel de la cicatriz de la tumorectomía. El resultado estético obtenido fue favorable en la valoración de las pacientes. Conclusiones. La reconstrucción mediante malla de Vicryl en casos seleccionados se presenta como una técnica fácil, resolutiva, rápida y con buenos resultados valorados por el médico y el paciente (AU)
Purpose. To evaluate the results of breast-conserving surgery for breast cancer by using polyglactin 910 absorbable mesh. Patients and method. Prospective case series of patients undergoing conservative breast surgery using polyglactin 910 mesh. Patients were included if the size of resection made a favourable aesthetic result unlikely. The study was conducted in a tertiary hospital during the period 2010-2015. Results. A total of 46 women underwent this technique. The mean age of the patients was 57 years. Postoperative morbidity occurred in two patients (4.3%) due to surgical site infection, which required mesh removal in one and was resolved with intravenous antibiotics in the other. In three patients (6.5%), total mastectomy was performed because delayed pathological analysis revealed margin involvement. There were no difficulties in the radiological follow-up, or radiological recurrences in the breast parenchyma, although a cutaneous recurrence was detected at the lumpectomy scar. Patient assessment of the aesthetic result was favourabe. Conclusions. Reconstruction using polyglactin 910 mesh in selected patients is an easy, decisive, and rapid technique. Patient and physician assessment was favourable (AU)
Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms/surgery , Breast Neoplasms , Mammaplasty/methods , Surgical Mesh , Polyglactin 910/therapeutic use , Sentinel Lymph Node Biopsy/methods , Ultrasonography, Mammary , Prospective StudiesABSTRACT
BACKGROUND: Intestinal malrotation is a congenital anomaly of the intestinal rotation and fixation, and usually occurs in the neonatal age. OBJECTIVE: Description of a clinical case associated with acute occlusive symptoms. CLINICAL CASE: A case of intestinal malrotation is presented in a previously asymptomatic woman of 46 years old with an intestinal obstruction, with radiology and surgical findings showing an absence of intestinal rotation. CONCLUSIONS: Intestinal malrotation in adults is often asymptomatic, and is diagnosed as a casual finding during a radiological examination performed for other reasons. Infrequently, it can be diagnosed in adults, associated with an acute abdomen.
Subject(s)
Ileal Diseases/diagnosis , Intestinal Volvulus/diagnosis , Jejunal Diseases/diagnosis , Abdomen, Acute/etiology , Female , Humans , Ileal Diseases/complications , Ileal Diseases/diagnostic imaging , Ileal Diseases/surgery , Ileum/blood supply , Ileum/surgery , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestinal Volvulus/complications , Intestinal Volvulus/diagnostic imaging , Intestinal Volvulus/surgery , Ischemia/etiology , Ischemia/surgery , Jejunal Diseases/complications , Jejunal Diseases/diagnostic imaging , Jejunal Diseases/surgery , Laparotomy , Middle Aged , Tomography, X-Ray ComputedABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Breast Neoplasms/pathology , Carcinoma/pathologyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Ischemia/complications , Ischemia/diagnosis , Hypertension/complications , Atrial Fibrillation/complications , Atrial Fibrillation/diagnosis , Cardiomyopathy, Hypertrophic/complications , Cardiomyopathy, Hypertrophic/diagnosis , Laparotomy/methods , Angiography/methods , Risk Factors , Atrial Fibrillation/physiopathology , Atrial Fibrillation/therapy , Abdominal Pain/complications , Abdominal Pain/diagnosisABSTRACT
No disponible
