Search results for "chirurgia"
showing 10 items of 1439 documents
Localization of sentinel lymph node in breast cancer. A prospective study
2014
Abstract Introduction Sentinel Lymph Node Biopsy (SLNB) is the standard of care for staging axillary lymph nodes in women with breast cancer and clinically negative nodes. It is associated with reduced arm morbidity, moderated or severe lymphoedema, and a better quality of life in comparison with standard axillary treatment. Unfortunately, skip metastases makes all minimally invasive approaches, such as axillary sampling, unreliable. The aim of the present clinical prospective study is to evaluate the position of SLN in an important number of cases and establish the real incidence of skip metastases in clinically node-negative patients. Patients and methods A cohort of 898 female patients w…
Double Endocrine Neoplasia in a Renal Transplant Recipient: Case Report and Review of the Literature
2011
Abstract Introduction The incidence of cancer compared for age groups is 3–4 times higher in transplant recipients than the general population. The increased risk is related to immunosuppressive therapy as well as the use of increasingly older donors and recipients. Although cardiovascular disease with a functioning transplant is the leading cause of death (47%), cancer mortality is significant especially among older patients. However, the most frequent posttransplantation cancers relate to hemolymphopoietic organs and skin, whereas the occurrence of solid tumors elsewhere is rare. Herein we have described a rare case of synchronous double malignancy of endocrine organs (thyroid-adrenal) in…
Intratissular expansion–mediated, serial fat grafting: A step-by-step working algorithm to achieve 3D biological harmony in autologous breast reconst…
2016
Background Breast reconstruction involves the use of autologous tissues or implants. Occasionally, microsurgical reconstruction is not an option because of insufficient donor tissues. Fat grafting has become increasingly popular in breast surgery. The challenge with this technique is how to reconstruct a stable and living “scaffold” that resembles a breast. Methods Breast reconstruction (n = 7) was performed using intratissular expansion with serial deflation–lipofilling sessions. Mean age of the patients was 41 years (22–53). The expander generated a vascularized capsule at 8 weeks, which demarcated a recipient site between the skin and the capsule itself, and functioned as a vascular sour…
The value of intraoperative frozen section examination of sentinel lymph nodes in surgical management of breast carcinoma.
2009
PURPOSE: In breast cancer staging, the need for intraoperative sentinel lymph node (SLN) evaluation has still not been adequately established. This study investigates the impact of intraoperative frozen section (FS) evaluation of SLN to avoid subsequent axillary lymph node dissection (ALND) in patients with positive SLN. METHODS: A retrospective review of 364 breast cancer patients undergoing SLN biopsy with intraoperative FS evaluation of SLN was performed. RESULTS: Sensitivity and accuracy of FS examination of SLN were 76.4% and 94.2%, respectively. The sensitivity was significantly higher in larger tumors (p < 0.01). No significant correlation was found between FS and histologic type. A …
Fully robotic left hepatectomy for malignant tumor: technique and initial results
2018
Robotic liver surgery has been considered as a unique opportunity to overcome the traditional limitations of laparoscopy; thus, it can potentially extend the indications of minimally invasive liver surgery. From April 2015 to May 2017, 35 patients underwent fully robotic left hepatectomy. The mean operative time was 315 min (200-445 min) and the mean estimated blood loss was 245 ml (125-628 ml). Pringle maneuver was required in six cases. Cancer was the indication for surgery in all patients (14 liver metastases, 18 hepatocellular carcinomas and 3 cholangiocarcinomas). There were one to four lesions in a patient and the mean lesion size was 39.2 mm (15-85 mm). The average length of hospital…
Laparoscopic Splenectomy for Secondary Cytoreduction in Ovarian Cancer Patients With Localized Spleen Recurrence: Feasibility and Technique
2016
Abstract Study Objective To investigate the feasibility of laparoscopic splenectomy in patients with recurrent ovarian cancer with isolated spleen metastasis. Design (Canadian Task Force classification III). Setting Tertiary referral centre in Rome, Italy. Patients Eight women with an isolated platinum-sensitive splenic relapse of ovarian cancer. Intervention Between February 2013 and May 2015, 8 women with an isolated platinum-sensitive splenic relapse of ovarian cancer were submitted to laparoscopic splenectomy. Measurements and Main Results All patients underwent laparoscopic splenectomy without conversion to an open approach. The median estimated intraoperative blood loss was 100 mL (ra…
Laser treatment of giant xanthelasma palpebrarum
2013
Xanthelasma palpebrarum is the most common cutaneous xanthoma. It typically presents in middle-aged and older adults, most often around the eyelids. The diagnosis is made clinically. Giant xanthelasmas palpebrarum are xanthelasmas that extensively affect the superior and inferior bilateral eyelids. Many techniques have been put forward for treating these lesions (surgical, laser, and chemical techniques), but we describe our experience in the treatment of giant xanthelasmas by ultrapulsed CO2 laser. Between 2009 and 2012, in the Division of Plastic and Reconstructive Surgery at the University of Palermo, 12 patients with giant xanthelasmas were treated using a CO2 laser. The laser parameter…
Bilateral DIEP Flap Breast Reconstruction to a Single Set of Internal Mammary Vessels: Technique, Safety, and Outcomes after 250 Flaps.
2019
BACKGROUND: The deep inferior epigastric artery perforator (DIEP) flap is considered the gold standard in autologous breast reconstruction. In bilateral cases, both flaps are often anastomosed to the internal mammary vessels on either side of the sternum. The authors propose a method in which both flaps are anastomosed to only the right side internal mammary artery and vein. METHODS: Between November of 2009 and March of 2018, 125 patients underwent bilateral DIEP flap breast reconstruction with this technique. One flap is perfused by the anterograde proximal internal mammary artery and the second one by the retrograde distal internal mammary artery after presternal tunneling. Patient demog…
Chimney and periscope grafts to facilitate endovascular treatment of aortic transection in a patient with aberrant right subclavian artery
2014
Purpose: To report the use of parallel grafts to extend the proximal landing zone for stentgraft repair of aortic transection involving an aberrant right subclavian artery (ARSA). Case Report: A 28-year-old patient was referred for treatment of traumatic aortic transection with contained rupture at the level of an ARSA. Immediate thoracic endovascular aortic repair (TEVAR) was planned because of hemodynamic instability. To achieve rapid sealing and maintain perfusion to both subclavian arteries, a chimney stent to the left subclavian artery (LSA) and a periscope stent-graft to the ARSA were deployed successfully. After surgical repair of all fractures, the patient was discharged 1 month aft…
Intravenous recombinant erythropoietin does not lead to an increase in cerebrospinal fluid erythropoietin concentration
2000
No abstract