ABSTRACT
The aim of this study was to evaluate the effectiveness of sentinel node (SN) biopsy in breast cancer. Twenty-five female patients classified as T1N0 according to the TNM system of the UICC were evaluated with this procedure from April to October 1999. The day before surgery a subdermal injection of 99mTc-nanocoll within the tissue overlying the neoplastic lesion and subsequent lymphoscintigraphy were performed. In all patients the SN was detected with a radioguided probe during scintigraphy and surgery. Histological examination of the SN for detection of metastases was positive in four patients who subsequently underwent axillary dissection. In the remaining patients with normal SNs no axillary dissection was performed. The preliminary results confirm the validity of the sentinel node procedure.
Subject(s)
Breast Neoplasms/pathology , Breast Neoplasms/surgery , Lymph Nodes/pathology , Lymph Nodes/surgery , Radiosurgery , Sentinel Lymph Node Biopsy/methods , Adult , Aged , Breast Neoplasms/diagnostic imaging , Female , Humans , Lymph Node Excision/methods , Lymph Nodes/diagnostic imaging , Lymphatic Metastasis/diagnostic imaging , Middle Aged , Neoplasm Staging , Radionuclide Imaging , Reproducibility of ResultsABSTRACT
The authors perform a retrospective analysis of 46 cases of EGC referred to the Surgical Division of Carrara Civic Hospital during the period 1980-1990 who subsequently underwent surgery. Data relating to age, symptomatology and endoscopic examinations were analysed in order to evaluate the real diagnostic penetration of the method in association with tumour biopsy, site, macroscopic aspect, possible lymph node involvement and the histology of lesions. The most frequent form of surgery in this series was subtotal gastrectomy and the 5- and 10-year survival rates, calculated using an actuarial method, were compared with data reported in the literature. The authors conclude by emphasising the need to improve the frequency of diagnosis of gastric cancer at an "early" stage and affirm that gastric resection associated with lymphoadenectomy of 1st and 2nd level lymph nodes is a sufficiently radical operation and less punitive for the patient compared to total gastrectomy given that the 5- and 10-year survival rates are comparable.
Subject(s)
Stomach Neoplasms/surgery , Adult , Aged , Biopsy , Female , Gastrectomy , Humans , Lymph Node Excision , Male , Middle Aged , Stomach/pathology , Stomach Neoplasms/mortality , Stomach Neoplasms/pathology , Time FactorsABSTRACT
The authors report on their initial experience with pylorus-preserving pancreatoduodenectomy. In the last three years 11 patients with neoplastic disease of the pancreatic head and ampullary region underwent the above mentioned procedure. The surgical technique carefully preserved the blood supply and innervation to the antro-pyloric region and duodenum was transected 2 cm distal to the pylorus. Postoperative mortality was 9%. Postoperative nasogastric suction was required for eight days (median). Long term results are quite good with a satisfactory restoration of intestinal function and a weight gain of 95% of pre-illness weight. At the present time preserving the pylorus appears an usefull modification of Whipple procedure.
Subject(s)
Ampulla of Vater , Common Bile Duct Neoplasms/surgery , Duodenum/surgery , Pancreatectomy/methods , Pancreatic Neoplasms/surgery , Adenocarcinoma/surgery , Adult , Aged , Anastomosis, Surgical/methods , Common Bile Duct/surgery , Female , Humans , Jejunum/surgery , Male , Middle Aged , Pancreas/surgery , PylorusSubject(s)
Rectal Neoplasms/surgery , Surgical Staplers , Colon/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications , Rectum/surgery , Time FactorsSubject(s)
Electric Stimulation Therapy/methods , Surgical Procedures, Operative , Transcutaneous Electric Nerve Stimulation/methods , Adolescent , Adult , Aged , Blood Pressure , Child , Ear, External , Evaluation Studies as Topic , Female , Flunitrazepam , Heart Rate , Humans , Male , Middle Aged , Preanesthetic MedicationSubject(s)
Breast Neoplasms/surgery , Breast Neoplasms/mortality , Female , Humans , Lymphatic Metastasis , Mastectomy , Postoperative CareSubject(s)
Duodenal Ulcer/complications , Peptic Ulcer Hemorrhage , Stomach Ulcer/complications , Adolescent , Adult , Aged , Female , Gastrectomy , Humans , Male , Middle AgedSubject(s)
Gastrectomy , Peptic Ulcer Perforation/surgery , Adult , Aged , Female , Humans , Infant, Newborn , Male , Middle AgedSubject(s)
Subclavian Steal Syndrome/surgery , Adult , Aged , Blood Vessel Prosthesis , Humans , Male , Polyethylene Terephthalates , Subclavian Artery/surgerySubject(s)
Carcinoma, Bronchogenic/surgery , Lung Neoplasms/surgery , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Wedged hepatic venography has been utilized in the hemodynamic staging of portal hypertension in 33 patients. The immediate postoperative evaluation in 18 cases, has outlined a portal vein filling in 14 end-to-side portacaval shunts, in 5 with presence of hepatofugal collateral veins between the ligated hepatic and shunted splanchnic sides of the portal system, and in 2 side-to-side. The sinusoidal filling pattern has been relatively unchanged after end-to-side portacaval shunts. The venographic appearance of "spontaneous" reversal of portal blood flow in hepatic cirrhosis must be confirmed by selective hepatic arteriography before affirming its presence.
