RESUMO
Introducción: La necrosis del complejo areola-pezón constituye una de las complicaciones más temidas en mamoplastias. Se plantea que el uso de la tomosíntesis constituye el método ideal para la valoración del pedículo vascular, con el fin de establecer la mejor técnica quirúrgica, para evitar esta complicación. Objetivo: Evaluar la utilidad del uso de la tomosíntesis como parte del protocolo preoperatorio para mamoplastias, en el periodo enero de 2015 a diciembre de 2016. Métodos: El estudio es de tipo retrospectivo, descriptivo. La muestra fue de 67 pacientes, de las cuales dos fueron excluidas por no tener registro de todos los datos. Se realizó tomosíntesis y ultrasonido mamario al 100 % de las pacientes. Resultados: Solo una paciente presentó necrosis parcial del complejo areola-pezón. Conclusiones: El uso de la tomosíntesis por sí sola, como método de imagen en la evaluación preoperatoria de mamoplastias, ayuda a planificar la técnica quirúrgica por emplear y a disminuir las complicaciones.
Introduction: The necrosis of the nipple areola complex is one of the most feared complications in mammoplasties. We propose that the use of thomosynthesis constitutes the ideal method for the evaluation of the vascular pedicle, and thus determine the best surgical technique, in order to avoid this complication. Objective: To evaluate the usefulness of the use of thomosynthesis as part of the preoperative protocol for secondary mammoplasties, from January 2015 to December 2016. Methods: The study is a retrospective, descriptive study. The sample consisted of 67 patients, of whom two were excluded because they did not record all the data. Breast ultrasound and thomosynthesis were performed in 100% of the patients. Results: Only one patient presented partial nipple areola complex necrosis. Conclusions: The use of thomosynthesis alone as an imaging method in the preoperative evaluation of mammoplasties helps to plan the surgical technique to be used as well as to reduce complications
Assuntos
Mamografia , Mamoplastia , MamilosRESUMO
BACKGROUND: Every year, over 1 million cardiac surgical procedures are performed all over the world. Reducing myocardial necrosis could have strong implications in postoperative clinical outcomes. Volatile anaesthetics have cardiac protective properties in the perioperative period of cardiac surgery. However, little data exists on the administration of volatile agents during cardiopulmonary bypass. The aim of this study was to assess if volatile anaesthetics administration during cardiopulmonary bypass reduces cardiac troponin release after cardiac surgery. MATERIALS AND METHODS: We retrospectively analysed data from 942 patients who underwent cardiac surgery in a teaching hospital. The only difference between the groups was the management of anaesthesia during CPB. The volatile group received sevoflurane or desflurane while the control group received a combination of propofol infusion and fentanyl boluses. Patients who received volatile anaesthetics during cardiopulmonary bypass (n=314) were propensity-matched 1:2 with patients who did not receive volatile anaesthetics during CPB (n=628). RESULTS: We found a reduction in peak postoperative troponin I, from 7.8 ng/ml (4.8-13.1) in the non-volatile group to 6.8 ng/ml (3.7-11.8) in the volatile group (p=0.013), with no differences in mortality [2 (0.6%) in the volatile group and 2 (0.3%) in the non-volatile group (p=0.6)]. CONCLUSIONS: Adding volatile anaesthetics during cardiopulmonary bypass was associated with reduced peak postoperative troponin levels. Larger studies are required to confirm our data and to assess the effect of volatile agents on survival.
