Assuntos
Hérnia Ventral/cirurgia , Herniorrafia/métodos , Hérnia Incisional/cirurgia , Laparoscopia/métodos , Idoso , Humanos , Masculino , Recidiva , Reoperação , Telas CirúrgicasRESUMO
INTRODUCTION: Hepatitis C (HCV) cirrhosis is the prevalent liver disease requiring liver transplantation in the United States. Candidates who also have end-stage renal disease, chronic renal disease stage 4, or prolonged hepatorenal syndrome are considered for combined liver and kidney transplantation (CLKT). MATERIALS AND METHODS: We performed a retrospective study of HCV(+) and HCV(-) CLKT patients with more than 12 months of follow-up and HCV(+) patients with isolated liver transplant (OLT) to compare the outcomes of various groups. RESULTS: Since 1988, 2983 OLTs were performed at our institution including 58 CLKTs. Of these, 23 were HCV(+) subjects who were significantly older than HCV(-) CLKT patients. Race, pretransplant dialysis time, renal indication for CLKT, Model for End-stage Liver Disease score, donor age, liver and kidney rejection as well as occurrence of posttransplant hypertension were similar among HCV(+) and HCV(-) CLKT patients. Posttransplant diabetes was observed in 80% of the HCV(+) group and 30% of the HCV(-) group (P = .01). Renal function seemed to be better in HCV(-) when compared with HCV(+) subjects at 5 years (P = .09). Overall patient survival for HCV(+) CLKT, HCV(-) CLKT, and HCV(+) OLT groups at 1, 2, and 5 years were not significantly different (P = .6). CONCLUSION: HCV positivity should not exclude appropriate candidates for CLKT.
Assuntos
Hepatite C/cirurgia , Transplante de Rim/fisiologia , Transplante de Fígado/fisiologia , Adulto , Idoso , Biópsia , Feminino , Seguimentos , Humanos , Transplante de Rim/mortalidade , Transplante de Rim/patologia , Transplante de Fígado/mortalidade , Transplante de Fígado/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Sobreviventes , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: The most common type of gallbladder cancer is the adenocarcinoma. The squamous cell carcinoma represents only a 0-12% of all gallbladder tumors. METHODS: 124 cases of malignant neoplasias of the gallbladder were diagnosed during the last 33 years in the Department of Surgery of our hospital. From these cases, 5 were squamous cell carcinomas, representing 2.41% of our series. CASE REPORT: The ratio female: male was 1.5:1, and the mean age was 50.2 years. Liver involvement was observed in 4 of 5 patients at the moment of diagnosis. Four patients underwent surgery and one received palliative treatment with percutaneous bile dreinage. The mean survival was 14.5 months. CONCLUSION: The tumor extention at the time of diagnosis is generally advanced and the outcome is not promising in this kind of gallbladder cancer.
Antecedentes: El tumor maligno de vesícula más frecuente es el adenocarcinoma. El carcinoma epidermoide representa solamente el 0-12% de todos ellos. Métodos: Se analizaron retrospectivamente 124 casos de neoplasias malignas de vesícula biliar diagnosticadosen los últimos 33 años en nuestro Servicio de Cirugía. Cinco resultaron ser carcinomas epidermoides,lo que representa un 2.41%. Casos: La relación mujer: varón fue de 1.5:1, y la edad media de presentación, 50.2 años. El compromiso hepático se observó en4 de los 5 pacientes en el momento del diagnóstico. Cuatro pacientes fueron sometidos a cirugía y un pacientea tratamiento paliativo con drenaje biliar percutáneo. La sobrevida media fue de 14.5 meses. Conclusión: La extensión tumoral en el momento deldiagnóstico es, en general, avanzada, por lo que el pronóstico en esta estirpe de cáncer de vesícula no es promisorio.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Carcinoma de Células Escamosas , Neoplasias da Vesícula Biliar , Argentina , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Distribuição por Sexo , Estudos Retrospectivos , Neoplasias da Vesícula Biliar/diagnóstico , Neoplasias da Vesícula Biliar/terapiaRESUMO
BACKGROUND: The most common type of gallbladder cancer is the adenocarcinoma. The squamous cell carcinoma represents only a 0-12% of all gallbladder tumors. METHODS: 124 cases of malignant neoplasias of the gallbladder were diagnosed during the last 33 years in the Department of Surgery of our hospital. From these cases, 5 were squamous cell carcinomas, representing 2.41% of our series. CASE REPORT: The ratio female: male was 1.5:1, and the mean age was 50.2 years. Liver involvement was observed in 4 of 5 patients at the moment of diagnosis. Four patients underwent surgery and one received palliative treatment with percutaneous bile dreinage. The mean survival was 14.5 months. CONCLUSION: The tumor extention at the time of diagnosis is generally advanced and the outcome is not promising in this kind of gallbladder cancer.(AU)
Antecedentes: El tumor maligno de vesícula más frecuente es el adenocarcinoma. El carcinoma epidermoide representa solamente el 0-12% de todos ellos. Métodos: Se analizaron retrospectivamente 124 casos de neoplasias malignas de vesícula biliar diagnosticadosen los últimos 33 años en nuestro Servicio de Cirugía. Cinco resultaron ser carcinomas epidermoides,lo que representa un 2.41%. Casos: La relación mujer: varón fue de 1.5:1, y la edad media de presentación, 50.2 años. El compromiso hepático se observó en4 de los 5 pacientes en el momento del diagnóstico. Cuatro pacientes fueron sometidos a cirugía y un pacientea tratamiento paliativo con drenaje biliar percutáneo. La sobrevida media fue de 14.5 meses. Conclusión: La extensión tumoral en el momento deldiagnóstico es, en general, avanzada, por lo que el pronóstico en esta estirpe de cáncer de vesícula no es promisorio.(AU)