RESUMEN
PURPOSE: The aim of the present study was to evaluate the feasibility and efficacy of laparoscopic ventral hernia repair under spinal anesthesia in obese patients (BMI > 30 kg/m(2)). METHODS: From January 2007 to February 2010, 23 obese patients had their elective laparoscopic ventral hernia repair under spinal anesthesia. We looked primarily for intra-operative incidences as well as immediate postoperative complications. Long term results and especially recurrences were also to be evaluated. RESULTS: Median operative time was 55 min (range 20-100). Intraoperatively, six patients (26%) complained of shoulder pain, three patients (13%) developed bradycardia and two (8.7%) hypotension. Postoperatively, nausea and/or vomiting were recorded in four patients (17.4%), four patients (17.4%) experienced urinary retention and one patient developed wound infection. Median pain score at 4th, 8th and 24th postoperative hour was 0.5 (0-5), 1.5 (0-6), and 1.5 (0-5) respectively. The median length of hospital stay was one day (1-2). At a median follow up of 39 months, one patient was diagnosed with a recurrence. CONCLUSION: Spinal anesthesia for LVHR in obese patients (BMI > 30 kg/m(2)) proved an efficient and safe alternative to general anesthesia in the given patient sample.
Asunto(s)
Anestesia Raquidea/métodos , Hernia Ventral/cirugía , Herniorrafia/métodos , Laparoscopía/métodos , Obesidad/fisiopatología , Adulto , Anciano , Comorbilidad , Femenino , Herniorrafia/efectos adversos , Humanos , Laparoscopía/efectos adversos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
A new technique of dividing the hepatic parenchyma in liver resections is presented. Seven liver resections in six patients were carried out, using a modification of the Radiofrequency assisted hepatectomy technique. The transection zone of the liver was coagulated prior to the division of the parenchyma using a transformed cluster cool-tip Radionics electrode. The reported technique resulted in adequate hemostasis of the raw hepatic surface and minimal blood loss. The aforementioned method seems to be quick and safe especially for local hepatic resections or segmentectomies.
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Ablación por Catéter , Hepatectomía/métodos , Hígado/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Hepatocellular carcinoma is a leading cause of cancer death worldwide in both adult and pediatric patients. Despite many options, no ideal treatment exists for this highly malignant tumor, and management strategies have varied accordingly. Angiogenesis, the formation of new blood vessels, is an essential component of hepatocellular carcinoma biology. Innovative approaches such as targeting the nontransformed, less resistant, tumor-supporting endothelial cells are currently under investigation in hepatocellular carcinoma. This review will focus on the current knowledge of the pathophysiology of hepatocellular carcinoma angiogenesis, as well as the reported data with angiogenesis inhibitors against hepatocellular carcinoma.
Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Carcinoma Hepatocelular/irrigación sanguínea , Carcinoma Hepatocelular/tratamiento farmacológico , Neoplasias Hepáticas/irrigación sanguínea , Neoplasias Hepáticas/tratamiento farmacológico , Ensayos Clínicos como Asunto , Humanos , Neovascularización PatológicaRESUMEN
The monoclonal antibody H (mAbH) detects an epitope consisting of an O-linked N-acetyl glucosamine (O-GlcNAc) and neighboring amino acids. This epitope has been found by using extracts from the MCF-7 human breast carcinoma cell line in immunoblotting experiments, on cytokeratin 8 (CK8) and 5 other polypeptides. In the present study, a double immunogold method was applied for the colocalization of CK8 and mAbH epitope on epoxy thin sections in 18 cases of infiltrating ductal breast carcinomas (IDBC) and in 6 cases of fibroadenomas, to study the accurate subcellular distribution of CK8 in breast cancer cells, as compared to the 5 polypeptides, recognized by mAbH. Furthermore, a detailed quantitative evaluation of the double immunolocalization over the cellular compartments of cancer cells was undertaken with the aid of a computerized image analysis system and the results were assessed statistically. The distribution pattern of CK8 and the mAbH epitope in the neoplastic mammary epithelial cells was similar in IDBC as compared to fibroadenomas, while the gold labeling intensity of these epitopes differed over the cellular compartments between malignant and benign biopsies. The results reveal the significance of the role of CK8 and O-GlcNAc glycosylation in the biology of the neoplastic mammary cells in vivo, determining their malignant potential.