RESUMEN
PURPOSE: The aim of this study was to determine the recall rate of screening ultrasound with automated breast volumetric scanning (ABVS) in women with dense breasts (BI-RADS density classification 3 or 4 on mammogram). MATERIALS AND METHODS: In this retrospective cohort study, at the end of the "first quarter" (August-October 2013) of use, our practice database was searched for all ABVS examinations performed and specifically, the positive examinations (defined as abnormal/BI-RADS 0) for which patients were recalled for additional imaging evaluation with handheld ultrasound (HHUS); the latter group was reviewed with respect to final BI-RADS and pathology if relevant. RESULTS: During the 3-month study time period, 558 ABVS studies were performed: 453 (81%) were initially BI-RADS 1 or 2 and 105 (19%) were BI-RADS 0-incomplete and recalled, corresponding with an overall recall rate of 19%; specifically, the recall rate trended down from 24.7% in August to 12.6% in October. To date, 98 of the 105 recalled women have returned for HHUS, with the resultant final BI-RADS as follows: 25/98=25% BI-RADS 1, 46/98=47% BI-RADS 2, 13/98=13% BI-RADS 3, 14/98=15% BI-RADS 4, and 0/98=0% BI-RADS 5. All biopsies performed to date of the ABVS-detected BI-RADS 4 lesions have yielded benign results, with the most common pathology being fibroadenoma. CONCLUSION: The recall rate of screening ABVS in women with dense breasts at our institution was under 20% overall during its first quarter of use, and trended down from nearly 25% in the first month to under 13% in the third. The clinical implication is that ABVS does have a learning curve, but that is a potentially feasible way to meet the increasing demands for screening ultrasound in women with dense breasts.
Asunto(s)
Mama/patología , Mamografía/métodos , Ultrasonografía Mamaria/métodos , Adulto , Anciano , Biopsia , Neoplasias de la Mama/diagnóstico por imagen , Estudios de Cohortes , Bases de Datos Factuales , Detección Precoz del Cáncer/métodos , Femenino , Fibroadenoma/diagnóstico , Fibroadenoma/patología , Humanos , Persona de Mediana Edad , Reconocimiento de Normas Patrones Automatizadas , Estudios RetrospectivosRESUMEN
BACKGROUND AND AIM: Case selection criteria for resection of liver metastasis after colorectal cancer are still incompletely elucidated and represent a subject of great interest recently. Our aim was to evaluate 2-year survival after resection and to identify the survival risk and prediction factors in those cases. METHODS: 63 patients diagnosed and undergoing liver resection for colorectal metastatic disease to the liver at the Surgical University Hospital No.3 (Cluj-Napoca, Romania) between 01.01.2002 and 31.12.2005 were included in the study. Exclusion criteria were: palliative treatment as well as surgical treatment performed in a different surgical centre. After the surgical treatment, patients were followed regularly using clinical assessment on a 3 monthly basis with abdominopelvic ultrasound or computerised tomography annually. The following variables were recorded: age, gender, coexisting medical diseases, blood tests results, tumour site, maximal tumour diameter after resection, duration of surgery, surgical procedure and the clinical outcome until last follow-up, including date of death where appropriate. RESULTS: 2-year post-operative survival was 65.1%. In univariate analysis: age (< 65 vs > = 65 years, p = 0.041), metastasis number (< 3 vs > = 3 tumors, p = 0.049), maximal tumor dimension (< 3 vs > = 3 cm, p = 0.047), glutamine-oxaloacetic transaminase (GOT) preoperative level (< 42 vs > = 42 mg/dl, p = 0.018) were significant factors correlated to median survival time. However, non of the above mentioned factors presented independent prediction power in multivariate analysis (Cox regression, p < 0.05). CONCLUSIONS: Our results support liver metastasis resection without prior case selection except for technically-operative criteria selection.
Asunto(s)
Adenocarcinoma/cirugía , Neoplasias Colorrectales/patología , Hepatectomía , Neoplasias Hepáticas/cirugía , Adenocarcinoma/secundario , Factores de Edad , Anciano , Femenino , Estudios de Seguimiento , Hospitales Universitarios , Humanos , Estimación de Kaplan-Meier , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios RetrospectivosRESUMEN
Laparoscopic surgery of the pancreas, acquisition of the recent years, finds application in the surgical management of pancreatic pseudocysts (PP). Among internal drainage procedures that can be performed through laparoscopic approach, the pseudocysto-jejunostomy technique (PJS) can be performed using only the standard laparoscopic instrument set. We submit the technique we used in performing a PJS on three patients admitted in our clinic. The postoperative outcome was favorable, having obtained identical results to those of the open approach. The mean duration of the interventions was 216.6 minutes. The mean postoperative hospitalization was 7 days. The laparoscopic approach allows internal drainage of PP in the form of PJS to be performed in good circumstances, also bringing about all the specific benefits of this type of surgery.