RESUMO
Postpneumonectomy syndrome (PPS) is a rare syndrome whereby the airway and oesophagus become obstructed due to extreme rotation of the mediastinum after pneumonectomy. Our treatment of this condition involved mediastinal repositioning and placement of a saline filled tissue expander into the pleural space. This has not been reported in the plastic surgical literature and we describe technical difficulties and how they were overcome.
Assuntos
Obstrução das Vias Respiratórias/cirurgia , Doenças do Esôfago/cirurgia , Pneumonectomia/efeitos adversos , Implantação de Prótese/métodos , Dispositivos para Expansão de Tecidos , Obstrução das Vias Respiratórias/etiologia , Criança , Doenças do Esôfago/etiologia , Feminino , Humanos , SíndromeRESUMO
Little literature exists on storage and preparation of an amputated limb prior to transfer to a reconstructive plastic surgical unit for possible macroreplantation. This paper describes practical measures used to prolong ischaemia time allowing macroreplantation, tissue harvesting, or fashioning of a useful stump. A simple protocol is used to summarise these points.
Assuntos
Amputação Traumática/cirurgia , Extremidades/lesões , Reimplante , Preservação de Tecido/métodos , Protocolos Clínicos , Extremidades/cirurgia , Humanos , Cuidados Pré-Operatórios/métodos , Manejo de Espécimes/métodosRESUMO
This paper discusses possible contraindications to sentinel node biopsy in cutaneous malignant melanoma based on a large series from our Melanoma Unit.
Assuntos
Melanoma/patologia , Complicações Neoplásicas na Gravidez/patologia , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/patologia , Aleitamento Materno , Contraindicações , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Hipersensibilidade/etiologia , Excisão de Linfonodo , Metástase Linfática , Melanoma/psicologia , Gravidez , Complicações Neoplásicas na Gravidez/psicologia , Prognóstico , Cintilografia , Neoplasias Cutâneas/psicologiaRESUMO
The aim of this paper is to explore current trends in the diagnosis, investigation and treatment of patients presenting with axillary lymph node metastases without a primary in the breast being found and, more rarely, those cases with metastatic breast cancer where the primary remains unknown--the so-called, 'occult' breast cancer. A retrospective study of 25 reported cases were selected from our database at the Royal Marsden and 6 patients were found to have true 'occult' breast cancer. These 6 patients are all still alive with no primary ever having been found in the breast. A literature review was then undertaken exploring the changing trends in this diagnostic enigma. MRI scanning, it is reported, may reveal the primary. Occult cancers in which imaging totally fails to show the primary will become increasingly rare. The prognosis of these, however, may be surprisingly better than one would expect from the nature of their presentation.