RESUMO
OBJECTIVES: This study analyzed oncological and functional results of supracricoid horizontal partial laryngectomy. METHODS: A retrospective study was conducted involving 20 patients with squamous cell carcinoma (SCC) of the larynx who underwent SCPL between 1996 and 2005 in Faculty of Medical Sciences of Santa Casa Hospital of Sao Paulo, Brazil. There were 18 male and 2 female patients with ages ranging from 39 to 74 years (median=58 years), of whom 19 were smokers and 14 alcoholics. The tumors were present in the glottis in 16 cases and supraglottis in 4; 5 were stage I or II and 15 were stage III or IV. We analyzed treatment given when rehabilitation was unsuccessful, oncological results of SCPL, including local and regional recurrences, time to recurrence and treatment given, distal metastases, global survival, survival free of disease, and appearance of second primary tumors. We also calculated the index of functional preservation of the larynx. RESULTS: Rehabilitation of swallowing capabilities and speech was achieved in 18 patients. Removal of the tracheostomy varied between 1 and 9 months. Rehabilitation was unsuccessful in two patients. Three patients required a total laryngectomy, two for unsuccessful rehabilitation and one for recurrence. The preservation of a functional larynx was 85%, with 10% of patients requiring a total laryngectomy after failed rehabilitation. CONCLUSIONS: Supracricoid horizontal partial laryngectomy is an efficient surgical oncology technique that yields good functional results for the treatment of laryngeal cancer.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Cartilagem Cricoide , Neoplasias Laríngeas/cirurgia , Laringectomia/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Resultado do TratamentoRESUMO
The proposal of this research was to obtain parameters to start or maintain cardiopulmonary resuscitation (CPR) in victims of trauma. The duration of the cardiac arrest and the CPR of the survivors was described, as well as the cerebral performance and the mortality of these victims 24, 48 and 72 hours after these events had happened. With the results of this characterization the relation between duration of cardiac arrest time, CPR and mortality were described. Data for this report were collected in Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo emergency department. A big amount of the victims (93.4%) presents severe trauma and main cause of death was brain injury. Survival at 72 hours after CPR was 10%. The assessment, during the 72 hour period, of the survivors from cardiac arrest of traumatic cause has shown bad cerebral performance of those victims in that period of time. The survivor after the first episode of CPR was strongly related to cardiac arrest time when compared with CPR time. The time of cardiac arrest < or = 4 minutes and CPR < or = 20 minutes was related to survival more than 72 hours.
Assuntos
Reanimação Cardiopulmonar/métodos , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Traumatismo Múltiplo/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Coma/etiologia , Feminino , Parada Cardíaca/mortalidade , Mortalidade Hospitalar , Hospitais Universitários , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo/classificação , Taxa de Sobrevida , Fatores de TempoRESUMO
No estudo epidemiologico, terapeutico e de relacao com o virus Epstein e Barr do Cancer da nasofaringe em Sao Paulo - Brasil, sao analisados: a) Anatomia da rinofaringe b) Incidencia, frequencia, distribuicao etaria e racial, c) Etiologia, d) Estudo clinico e biopsia e, h) Relacao com o virus Epstein e Barr