RESUMO
Liver resections are a significant source of primary human hepatocytes used mainly in artificial liver devices and pharmacological and biomedical studies. However, it is not well known how patient-donor and surgery-dependent factors influence isolated hepatocytes' yield, viability, and function. Hence, we aimed to analyze the impact of all these elements on the outcome of human hepatocyte isolation. Patients and methods: Hepatocytes were isolated from liver tissue from patients undergoing partial hepatectomy using a two-step collagenase method. Hepatocyte viability, cell yield, adhesion, and functionality were measured. In addition, clinical and analytical patient variables were collected and the use or absence of vascular clamping and its type (continuous or intermittent) plus the ischemia times during surgery. Results: Malignant disease, previous chemotherapy, and male gender were associated with lower hepatocyte viability and isolation cell yields. The previous increase in transaminases was also associated with lower yields on isolation and lower albumin production. Furthermore, ischemia secondary to vascular clamping during surgery was inversely correlated with the isolated hepatocyte viability. An ischemia time higher than 15 min was related to adverse effects on viability. Conclusion: Several factors correlated with the patient and the surgery directly influence the success of human hepatocyte isolation from patients undergoing liver resection.
RESUMO
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)
