RESUMO
BACKGROUND: Gastric stromal neoplasms are rare, accounting for < 2% of gastric tumors. Definite criteria for the malignant nature of such tumors are difficult to establish. Although their laparoscopic management has been described, there is still debate as to how to handle these tumors intraoperatively. METHODS: We report a new technical modification of laparoscopic resection used in two gastric stromal tumors, with special precautions taken to avoid the operative dissemination of unsuspected malignancy. RESULTS: The operative course and postoperative follow-up were uneventful. In both cases, histology showed no features of malignancy. CONCLUSION: To avoid tumor seeding during the resection of gastric stromal tumors, preventive measures--including absence of manipulation of the tumor, elimination of direct contact with the abdominal wall, and avoidance of disruption of the mucosa--should be implemented.
Assuntos
Laparoscopia/métodos , Neoplasias Gástricas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/patologia , Células Estromais/patologia , Técnicas de SuturaRESUMO
BACKGROUND: Folates, components of the B-complex vitamins, have numerous pharmacological effects. In oncology combining folates with 5-fluorouracil (5-FU) enhances the cytotoxic effects of chemotherapy in colon cancer patients. Folic acid has been rarely involved in adverse allergic reactions. To the best of our knowledge no anaphylactic reaction secondary to folinic acid (FA) administration has ever been reported before. PATIENTS AND METHODS: An 80-year-old patient had adjuvant chemotherapy for colon cancer including FA and 5-FU and irinotecan as a second line agent after multiple metastases. RESULTS: Following FA administration anaphylactic shock occurred. Diagnosis was made according to the French method of adverse reactions monitoring. CONCLUSION: Anaphylactic shock may be an adverse reaction of FA in patients receiving chemotherapy for colon cancer.
Assuntos
Anafilaxia/induzido quimicamente , Camptotecina/análogos & derivados , Leucovorina/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Camptotecina/administração & dosagem , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/patologia , Fluoruracila/administração & dosagem , Humanos , Injeções Intravenosas , Irinotecano , Leucovorina/administração & dosagem , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Masculino , Resultado do TratamentoRESUMO
Nearly 300,000 appendectomies are performed yearly in France. The negative laparotomy rate for suspected acute appendicitis is about 20%. Appendiceal perforation increases the risk of postoperative complications and may lead to death. Differential diagnosis of right lower quadrant abdominal pain is a major public health problem. Reported means of increasing diagnostic accuracy have included in-hospital observation with clinical and biological structured data collection with or without computer-assisted diagnosis, ultrasonography, CT, and laparoscopy. The ideal diagnostic test is yet to be defined. However, structured clinical examination is the cornerstone of any management algorithm. "When in doubt, take it out" is no longer acceptable.