Navegando por Palavras-chave "lymph node excision"
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- ItemAcesso aberto (Open Access)Can selective retroperitoneal lymphadenectomy be better than unilateral retroperitoneal lymphadenectomy?(Sociedade Brasileira de Urologia, 2003-10-01) Arruda, Homero O. [UNIFESP]; Paula, Adriano A.p. [UNIFESP]; Suarez, Ruben [UNIFESP]; Cury, José [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To propose a new modality of retroperitoneal lymphadenectomy as a complementary treatment for patients with high risk, stage I nonseminomatous testicular tumor. MATERIALS AND METHODS: We studied 76 patients with stage I nonseminomatous testis tumor (T1-T4, NX, M0) treated by orchiectomy and retroperitoneal lymphadenectomy. Among them, 33 patients underwent unilateral retroperitoneal lymphadenectomy (URL) and 43 selective retroperitoneal lymphadenectomy (SRL). URL consisted in removing the lymph nodes located around the great vessel homolateral to the tumor (aorta or vena cava and iliac vessels), and anterior and posterior to the contralateral great vessel (aorta or vena cava). SRL was performed removing the lymph nodes located anterior and between the great vessels (aorta or vena cava) and laterally to the homolateral great vessel, extending the distal dissection until the level of inferior mesenteric artery. In these groups of patients, the incidence of disease recurrence, disease-free survival index, and frequency of post-operative aspermia were assessed. Mean post-operative follow-up time was 96 months. RESULTS: In the SRL group there was only 5% of aspermia versus 79% in the URL group (p < 0.0001). Tumor recurrence was observed in only 5 of the 76 patients and was not related to the surgical technique. The disease-free survival rate after the mean follow-up of 96 months was similar in both groups, being 94% in the SRL group and 93% in the URL group. CONCLUSION: The selective retroperitoneal lymphadenectomy constitutes an effective technique with a lower morbidity than unilateral lymphadenectomy, representing an excellent option for the management of patients with high-risk, stage I nonseminomatous testis tumor.
- ItemAcesso aberto (Open Access)Incidência da escápula alada e morbidade dos membros superiores de pacientes no pós-operatório do tratamento do câncer de mama com abordagem axilar(Universidade Federal de São Paulo (UNIFESP), 2015-02-28) Rizzi, Samantha Karlla Lopes de Almeida [UNIFESP]; Facina, Gil [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The incidence of winged scapula was 8.03% after 15 days of surgery breast cancer with axillary approach. After six months postoperatively the prevalence dropped to 3.27%. 2) The scapular winging was associated with higher frequency of lymphadenectomy Axillary (22.58%) compared to the sentinel lymph node biopsy (2.86%). There was no significant difference in the incidence of different types of breast surgery. 3) dyskinesia scapula increased, mainly from three months surgery. 4) The presence of scapular asymmetry did not change over six months postoperative, or had no relation to the appearance of winged scapula or increased dyskinesia scapula after surgery. 5) There was a decrease in the amplitude of flexion, adduction, abduction and shoulder external rotation postoperative recovery and amplitude average of all movements during the six months post-surgery. 6) The increased pain after surgery, but remained low throughout the follow-up and six months after surgery showed no difference when compared to the preoperative phase. 7) The scapular winging was associated with greater morbidity for shoulder the movements of flexion, abduction and adduction, no difference to ache.
- ItemSomente MetadadadosSentinel lymph node in endometrial cancer(Blackwell Publishing, 2007-09-01) Lopes, L. A. F.; Nicolau, S. M.; Baracat, F. F.; Baracat, E. C.; Goncalves, Wagner Jose [UNIFESP]; Santos, H. V. B.; Lopes, R. G.; Lippi, U. G.; Hosp Servidor Publ Estadual São Paulo Francisco M; Universidade Federal de São Paulo (UNIFESP)The aim of this study was to evaluate the possibility of identifying the sentinel lymph node and involvement of neoplastic cells in patients with endometrial carcinoma limited to the uterus, and also its correlation with the conditions of other pelvic and para-aortic lymph nodes. Forty patients with endometrial carcinoma, clinical staging I and II, were submitted to complete surgical staging through laparotomy, as recommended by FIGO in 1988. the sentinel node was investigated using patent blue dye in the myometrial subserosa. the sentinel node was excised and submitted to frozen section examination of specimen, stained with hematoxylin and eosin (H&E). Afterward, selective bilateral para-aortic and pelvic lymphadenectomy, total hysterectomy with bilateral salpingo-oophorectomy were performed. the lymph nodes excised were examined by means of paraffin-embedded slices stained with H&E and of imunohistochemistry with antikeratin antibody AE1/AE3. the sentinel lymph node was identified in 77.5% of patients (31/40), and 16.1% (5/31) presented neoplastic involvement in the node. in 25 cases of negative sentinel node, 96% (24/25) had no neoplastic involvement, and 4% (1/25) had other lymph node affected (false negative). in nine cases with no sentinel node identified, 55.5% (5/9) had lymph node involvement. the results of this study allow us to conclude that it is possible to identify the sentinel node using the methods described, and the pathologic examination significantly represents the same conditions of other pelvic and para-aortic lymph nodes.