ABSTRACT
This case-control study assesses laparoscopic cholecystectomy (LC) in patients with end-stage renal disease treated with continuous ambulatory peritoneal dialysis. Eleven patients receiving peritoneal dialysis treatment and 33 patients without end-stage renal disease who had undergone an elective LC were compared. Medical records were reviewed, and laboratory values and outcomes and results were analyzed. The peritoneal dialysis group showed a higher frequency of associated disease and previous abdominal surgery; a lower hemoglobin and platelet count; and elevated alkaline phosphatase, blood urea nitrogen, and creatinine values. Statistically significant between-group differences were found with regard to postoperative complications and postoperative hospital stay days. One procedure in each group was converted to an open cholecystectomy. No patient in the peritoneal dialysis group who underwent a LC had peritonitis. No other catheter-related complications occurred. LC may be performed with low complication rates in patients undergoing continuous ambulatory peritoneal dialysis with an experienced team.
Subject(s)
Cholecystectomy, Laparoscopic , Kidney Failure, Chronic , Peritoneal Dialysis, Continuous Ambulatory , Adult , Case-Control Studies , Feasibility Studies , Female , Health Status Indicators , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the efficacy of Tc-HIG on SLN identification in patients with early-stage breast cancer. MATERIALS AND METHODS: Seventeen women (18 tumours) with early-stage breast cancer were included. On the day of the operation, 111 MBq Tc-HIG was injected around the tumour or biopsy scar in all patients. Subsequently, dynamic lymphoscintigraphic images were taken for 30 min. After this, static images were recorded at 15-20 min intervals until the SLN was visualized. Patients were taken to the operating room 2-4 h after radiopharmaceutical injection. Before the incision, 5 ml of isosulfan blue dye solution was injected peritumourally in all subjects. Aided by blue dye and gamma probe SLN detection was done during the operation. RESULTS: In 17/18 tumours, SLN was detected with Tc-HIG lymphoscintigraphy. The mean visualization time for axillary SLNs was 49.94+/-11.25 min and for internal mammary SLNs was 52.50+/-10.60 min. In 15 of the tumours, only one SLN was detected in the axillary region. However, in two tumours, SLNs were found in both axillary and internal mammary regions. With blue dye mapping, axillary SLNs were found in 17/18 tumours. With the application of intraoperative gamma probe, all axillary and internal mammary SLNs were detected in 18 tumours. CONCLUSION: We conclude that Tc-HIG may be a suitable agent for SLN detection by lymphoscintigraphy and intraoperative gamma probe application in early-stage breast cancer patients.
