RESUMEN
Cutaneous squamous cell carcinoma (SCC) is the second most common malignant skin tumour in the European population, with an annual estimated age-standardised incidence of 1-6 per 1000. After the head and neck, the upper and lower limbs are the most common sites affected with 14% of SCCs occurring in these areas. SCC has the potential to be a highly aggressive tumour but there are no recent studies looking at the long-term outcome of patients with extremity SCC. A retrospective study was performed of 243 patients with a total of 517 upper and lower extremity SCCs who had been followed up for at least 4yrs. All patients' lesions were studied at one institution and data was collected from the Medical and Histopathology records. We found that there is only a low rate of recurrence or metastasis for extremity SCCs and that patients had a good prognosis overall.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Extremidad Inferior , Neoplasias Cutáneas/cirugía , Extremidad Superior , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Comorbilidad , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Neoplasias Cutáneas/mortalidad , Neoplasias Cutáneas/patología , Resultado del TratamientoRESUMEN
Gynaecomastia reduction surgery is a common male cosmetic procedure. Our clinical experience suggested far lower rates of satisfaction than previously reported. Therefore we evaluated our patient group using a detailed questionnaire designed specifically to assess patient satisfaction with breast attributes and quality-of-life outcome following surgery. The questionnaire was sent to all patients who had surgery for gynaecomastia between January 2000 to January 2006. A total of 74 of the 120 patients contacted returned the questionnaire (62% overall response rate). The patients were divided into 3 groups according to their surgical treatment; liposuction only, excision only and combined excision plus liposuction. The majority of patients underwent surgery for reasons of self-confidence and emotional distress. In all groups surgery resulted in an increase in the mean Likert score (LS). The overall mean LS, combined from all the questions increased from 1.9 ('dissatisfied') to 3.2 ('neither satisfied nor dissatisfied'). Only 62.5% of all patients treated for gynaecomastia were 'satisfied' to 'very satisfied'. This more detailed study has shown that satisfaction rates are not as high as previously published. Patients must be appropriately counselled preoperatively to ensure they have realistic expectations of what can be achieved with surgery.
Asunto(s)
Ginecomastia/cirugía , Mamoplastia/métodos , Satisfacción del Paciente/estadística & datos numéricos , Adolescente , Adulto , Estética , Ginecomastia/diagnóstico , Ginecomastia/psicología , Humanos , Lipectomía/métodos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Autoimagen , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The chin is an important and often neglected feature of facial balance. Genioplasty is a useful procedure in aesthetic surgery and often can be combined with other procedures to obtain an optimal aesthetic outcome. A retrospective case note review of the senior author's (BMJ) experience of aesthetic genioplasty over an 11-year period was undertaken. Cases with non-aesthetic indications for genioplasty were excluded and overall 64 patients were included in this study. Our technique of intraoral osseous genioplasty is described and discussed. A total of 54 patients underwent osseous genioplasty, eight underwent alloplastic genioplasty and two underwent removal of a chin prosthesis only. Most of the patients who had an osseous genioplasty had a sliding advancement correction. Four of these patients required secondary surgery, five had additional minor complications and there were seven cases of transient numbness. Nine patients had a genioplasty alone, 26 had one additional procedure and 19 had more than one, with an average of 2.9 additional procedures. Twenty-four patients had a simultaneous rhinoplasty and 18 had a facelift. Osseous genioplasty is our preferred technique for its versatility and long-term stability compared to alloplastic methods. If performed correctly it provides excellent results with a high degree of patient satisfaction and few long-term complications.