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Superficial lymphadenectomy is an easy-to-perform and cost-effective routine technique. Despite its simplicity, it remains underutilized in veterinary medicine, with most practitioners being oncological surgeons. This study aims to enhance accessibility to the surgical procedure by providing anatomical representations of superficial lymphadenectomy in the carcasses of dogs and cats. A preliminary study involving two canines and two felines was conducted, with each group comprising a dog and a cat. Group A was designated to superficial lymphadenectomy techniques to create an illustrated step-by-step procedure, while group B underwent anatomical dissection to expose lymph nodes and their adnexa. The approach to superficial lymph nodes in dogs and cats is simple, allowing for the demonstration of superficial lymphadenectomy techniques in the corpses of dogs and cats without complications. This includes the dissection and presentation of anatomical structures adjacent to the lymph nodes. In conclusion, the techniques applied to subjects in groups A and B proved effective, successfully demonstrating and excising all superficial lymph nodes in the corpses of dogs and cats. These findings suggest that the developed set of techniques developed for lymph node excision holds promise for safe and effective application in live animals.

A linfadenectomia superficial é uma técnica de rotina de fácil execução e custo-benefício. Apesar da sua simplicidade, continua subutilizado na medicina veterinária, sendo a maioria dos profissionais cirurgiões oncológicos. Este estudo visa melhorar a acessibilidade ao procedimento cirúrgico, fornecendo representações anatômicas de linfadenectomia superficial em carcaças de cães e gatos. Foi realizado um estudo preliminar envolvendo dois cães e dois gatos, sendo cada grupo composto por um exemplar de cada espécie. O grupo A foi designado para técnicas de linfadenectomia superficial para criar um procedimento passo a passo ilustrado, enquanto o grupo B foi submetido à dissecção anatômica para expor os linfonodos e seus anexos. A abordagem dos linfonodos superficiais em cães e gatos é simples, permitindo a demonstração de técnicas de linfadenectomia superficial em cadáveres de cães e gatos sem complicações. Isto inclui a dissecção e apresentação de estruturas anatômicas adjacentes aos gânglios linfáticos. Concluindo, as técnicas aplicadas aos indivíduos dos grupos A e B mostraram-se eficazes, demonstrando e extirpando com sucesso todos os linfonodos superficiais nos cadáveres de cães e gatos. Essas descobertas sugerem que o conjunto desenvolvido de técnicas para excisão de linfonodos é promissor para aplicação segura e eficaz em animais vivos.

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Resumen El tumor maligno de la vaina nerviosa periférica (TMVNP) es un sarcoma de alto grado de malignidad. Es poco frecuente, agresivo y generalmente se localiza en tronco y miembros inferiores. Se presenta mayormente en pacientes con neurofibormatosis tipo 1, aunque no siempre se encuentra esta asociación. Este tumorcomparte características histológicas e inmunohistoquímicas con el melanoma, lo que puede dificultar el diagnóstico. Presentamos el caso de un paciente con TMVNP, en el cual los hallazgos histológicos iniciales condujeron a un diagnósticoerróneode melanoma.

Abstract Malignant peripheral nerve sheath tumor (MPNST) is a high-grade sarcoma. It is rare, aggressive and generally located on the trunk and lower limbs. It occurs in a high percentage of patients with neurofibormatosis type 1, although this association is not always found. This tumor shares histological and immunohistochemical characteristics with melanoma, which can make diagnosis difficult. We present the case of a patient with MPNST, in whom the initial histological findings led to an erroneous diagnosis of melanoma.

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Introducción: El consentimiento informado es un acto importante de la relación médico-paciente, constituye un proceso y un documento médico-legal-bioético trascendente de esta relación. En este sentido, el consentimiento se utiliza como una herramienta que favorece el diálogo y la comprensión durante el tratamiento quirúrgico. Objetivo: Brindar un análisis y actualización del tema desde el contexto de la cirugía oncológica por la importancia de esta temática en la actualidad. Métodos: Se realizó una revisión de la literatura relevante publicada sobre el tema en bases de datos PubMed, SciELO, Google Académico. Se priorizaron los últimos 5 años y los textos escritos en idiomas inglés y español. Se hizo énfasis en las palabras consentimiento, bioética y oncología. Se revisó un total de 35 artículos. Desarrollo: La creciente demanda de terapias novedosas en la medicina, y aún más en la oncología, ha planteado nuevos dilemas éticos para la sociedad. La toma de decisiones en cuestiones de salud es un elemento central de la autonomía. Existen diversos conceptos de entorno al paciente quirúrgico que padece de cáncer. Conclusiones: Aplicar la bioética a la práctica de la oncología permite acceder al escenario donde las decisiones pasan por un análisis ético. Cuando los principios bioéticos son ejercidos como un procedimiento habitual como es el consentimiento informado, la relación médico-paciente refleja acciones dirigidas a favorecer la comunicación, el respeto a la dignidad y el proceso al final de la vida.

Introduction: Informed consent is an important act of the doctor-patient relationship, it is a process and a medical-legal-bioethical document that is transcendent of this relationship. In this sense, consent is used as a tool that favors dialogue and understanding during surgical treatment. Objective: Provide an analysis and update of the topic from the context of oncological surgery due to the importance of this topic today. Methods: A review of the relevant literature published on the subject was carried out in PubMed, SciELO, Google Scholar databases, emphasizing the last 5-years, and in the English and Spanish languages, emphasizing the words consent, bioethics, and oncology. A total of 35 articles were reviewed. Development: The growing demand for novel therapies in medicine and even more in oncology, has raised new ethical dilemmas for society. Decision-making in health matters is a central element of autonomy, there are various concepts related to the surgical patient suffering from cancer. Hence the importance of consent and motivation of this work. Conclusions: Applying bioethics to the practice of oncology allows access to the scenario where decisions go through an ethical analysis. When bioethical principles are exercised as a regular procedure such as informed consent, the doctor-patient relationship reflects actions aimed at promoting communication, respect for dignity and the process at the end of life.

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INTRODUCTION AND IMPORTANCE: Nodular melanoma is the second most frequent cutaneous melanoma worldwide and due to its rapid growth rate and non-malignant appearance, is the most aggressive one. In its polypoid form, it is usually found in mucosal areas, but can also be seen on the trunk. This case is presented because it is an unusual manifestation and surgical treatment required wide excision, however, the patient's evolution is favorable. CASE PRESENTATION: 70-year-old female patient shows a progressively growing lesion with irregular border, abnormal color and a heterogeneous appearance. The biopsy yields the histological diagnosis of nodular polypoid melanoma. The surgical technique results in the resection of a 10 × 9 × 67 cm piece with favorable evolution of the patient. CLINICAL DISCUSSION AND CONCLUSIONS: The surgical technique of margin widening is considered a recommended option for polypoid nodular back melanomas. Although the excision is considered vast, the patient's evolution may turn out to be favorable.

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Se presenta un análisis de las clasificaciones previamente publicadas para las complicaciones que ocurren después de una cirugía realizada para extirpar un tumor que afecta a los huesos. En cuanto a la importancia de ofrecer una propuesta sencilla, fácil de entender, completa, y orientada a las posibilidades de manejo de esas complicaciones, se presenta una nueva propuesta de clasificación(AU)

An analysis of previously published classifications for complications happening after a surgery performed to remove a tumor affecting bones, is presented, and commented. Regarding the importance of offering a simple, easy to understand, complete, and aimed at the possibilities of management of those complications, a new proposal for classification is presented(AU)

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BACKGROUND: Cancer patients configure a risk group for complications or death by COVID-19. For many of them, postponing or replacing their surgical treatments is not recommended. During this pandemic, surgeons must discuss the risks and benefits of treatment, and patients should sign a specific comprehensive Informed consent (IC). OBJECTIVES: To report an IC and an algorithm developed for oncologic surgery during the COVID-19 outbreak. METHODS: We developed an IC and a process flowchart containing a preoperative symptoms questionnaire and a PCR SARS-CoV-2 test and described all perioperative steps of this program. RESULTS: Patients with negative questionnaires and tests go to surgery, those with positive ones must wait 21 days and undergo a second test before surgery is scheduled. The IC focused both on risks and benefits inherent each surgery and on the risks of perioperative SARS-CoV-2 infections or related complications. Also, the IC discusses the possibility of sudden replacement of medical staff member(s) due to the pandemic; the possibility of unexpected complications demanding emergency procedures that cannot be specifically discussed in advance is addressed. CONCLUSIONS: During the pandemic, specific tools must be developed to ensure safe experiences for surgical patients and prevent them from having misunderstandings concerning their care.

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RESUMEN Introducción: La magnitud de las resecciones de tumores de cabeza y cuello, depende del tamaño tumoral, la adecuación de los márgenes y factores inherentes al paciente. El músculo temporal, constituye una excelente opción para reconstruir defectos de zonas aledañas a su sitio de implantación. Objetivo: Demostrar la versatilidad del colgajo miofascial de temporal para la reconstrucción tras, cirugía oncológica de cabeza y cuello, en el Hospital Provincial Universitario "Camilo Cienfuegos Gorriarán" desde enero de 2017 a diciembre de 2018. Métodos: Se realizó una revisión retrospectiva de los informes operatorios de los casos intervenidos con cirugía oncológica de cabeza y cuello, en el servicio de cirugía maxilofacial; se tomó de muestra a pacientes a los que, se les realizó reconstrucción del defecto quirúrgico, utilizándose colgajo miofascial de temporal. Resultados: Fueron sometidos a reconstrucción, 12 pacientes de forma inmediata, en un solo tiempo quirúrgico. El defecto se presentó mayormente en lesiones de piel. La edad promedio de los pacientes fue 66,2 años. Se observó una distribución equitativa en cuanto a sexo, con 6 pacientes para cada grupo. El seguimiento osciló entre 2 y 20 meses, con una media de 11,25 meses, de los cuales todos los pacientes se encontraban vivos y controlados. Conclusiones: El colgajo temporal continúa siendo una opción válida para la reconstrucción en cirugía oncológica de cabeza y cuello. En la serie revisada no ocurrió necrosis, lo que, lo hace un colgajo muy seguro, con buenos resultados estéticos y funcionales y con buena tolerancia ante los tratamientos oncoespecíficos adyuvantes(AU)

ABSTRACT Introduction: The magnitude of the resections of head and neck tumors depends on the tumor size, the adequacy of the margins and factors inherent to the patient. The temporal muscle is an excellent option for reconstructing defects in areas surrounding its implantation site. Objective: To demonstrate the versatility of the temporal myofascial flap for reconstruction after oncological head and neck surgery, at the "Camilo Cienfuegos Gorriarán" Provincial University Hospital from January 2017 to December 2018. Methods: A retrospective review of the operative reports of the cases intervened with oncological head and neck surgery was performed in the maxillofacial surgery service; A sample was taken from patients who underwent reconstruction of the surgical defect, using a temporal myofascial flap. Results: 12 patients underwent reconstruction immediately, in a single surgical time. The defect occurred mainly in skin lesions. The average age of the patients was 66.2 years. An equitable distribution in terms of sex was observed, with 6 patients for each group. Follow-up ranged from 2 to 20 months, with a mean of 11.25 months, of which all the patients were alive and controlled. Conclusions: The temporary flap continues to be a valid option for reconstruction in head and neck cancer surgery. Necrosis did not occur in the revised series, which makes it a very safe flap, with good aesthetic and functional results and with good tolerance to adjuvant oncospecific treatments(AU)

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Colorectal cancer is the third most common cancer in the world and the fourth most common cause of death related to cancer. Signet ring cell carcinoma represents an uncommon histological type for rectal cancer with less than 1% of all rectal neoplasms. It usually behaves aggressively and has an inferior prognosis. We present the case of a young man diagnosed with signet ring cell rectal carcinoma. He underwent neoadjuvant therapy with partial response, had surgery with curative intent and showed local recurrence after only 3 months. Disease progression happened only weeks after recurrence with metastasis to vertebrae, extraocular muscles, bone marrow and skin. He is currently receiving palliative chemotherapy.

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Os sarcomas de tecidos moles (STM) são um grupo de diferentes tipos de tumores de origem mesenquimal; descritos como massas pseu-doencapsuladas com margens mal definidas que apresentam índices altos de recidiva local em comparação ao baixo a moderado potencial metastático. Ocorrem tanto em seres humanos quanto em animais; compreendem aproximadamente 15% de todos os tumores de pele e de subcutâneo em cães. Devido ao seu comportamento invasivo, a remoção cirúrgica é o tratamento indicado para os cães acometidos por tais tumores, incluindo-se também a radioterapia após ressecção incompleta, pois o papel da quimioterapia ainda é pouco conhecido.(AU)

Soft tissue sarcomas (STS), a heterogeneous group of different tumors of mesenchymal origin, are described as pseudo-encapsulated masses with poor defined margins that present high rates of local recurrence compared to the low to moderate metastatic potential. They can occur both in humans and animals, and in dogs they comprise approximately 15% of all skin and subcutaneous tumors. Due to its invasive behavior, surgery is the main treatment applied for these tumors in dogs, and it can be combined to radiotherapy after the incomplete resection because the role of chemotherapy is still very poorly understood in this subject. (AU)

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Os sarcomas de tecidos moles (STM) são um grupo de diferentes tipos de tumores de origem mesenquimal; descritos como massas pseu-doencapsuladas com margens mal definidas que apresentam índices altos de recidiva local em comparação ao baixo a moderado potencial metastático. Ocorrem tanto em seres humanos quanto em animais; compreendem aproximadamente 15% de todos os tumores de pele e de subcutâneo em cães. Devido ao seu comportamento invasivo, a remoção cirúrgica é o tratamento indicado para os cães acometidos por tais tumores, incluindo-se também a radioterapia após ressecção incompleta, pois o papel da quimioterapia ainda é pouco conhecido.

Soft tissue sarcomas (STS), a heterogeneous group of different tumors of mesenchymal origin, are described as pseudo-encapsulated masses with poor defined margins that present high rates of local recurrence compared to the low to moderate metastatic potential. They can occur both in humans and animals, and in dogs they comprise approximately 15% of all skin and subcutaneous tumors. Due to its invasive behavior, surgery is the main treatment applied for these tumors in dogs, and it can be combined to radiotherapy after the incomplete resection because the role of chemotherapy is still very poorly understood in this subject.

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O tratamento das lesões neoplásicas localmente avançadas de cólon permanece um desafio pelo envolvimento e invasão de órgãos como o pâncreas e o duodeno. Apresentamos um caso de câncer de cólon avançado de um paciente submetido a colectomia direita associada a duodenopancreatectomia. No seguimento de cinco anos, o paciente permanecia livre de doença. Apesar da elevada morbidade, a ressecção multivisceral associada a quimioterapia adjuvante apresenta boa sobrevida e até mesmo cura em longo prazo (AU)

The treatment of locally advanced neoplastic lesions of right colon remains a challenge due to the involvement and invasion of organs such as pancreas and duodenum. We report a case of advanced colon cancer of a patient that underwent right hemicolectomy in association with pancreaticoduodenectomy. The 5-year follow-up showed that the patient remained free of disease. Despite the high morbidity rate, multi-visceral resection associated with adjuvant chemotherapy seems to provide an increase in survival or even long-term cure (AU)

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Surgical-site infection (SSI) is the most prevalent type of hospital infection in surgical patients and is associated with an increase in hospital stay, costs and morbidity/lethality. The knowledge of the main risk factors for this type of infection is important for the establishment of prevention measures regarding modifiable risks factors. The objective of the preset study was to assess the occurrence of SSI and study the risk factors in oncologic surgeries of the digestive system at Hospital de Câncer in Barretos, São Paulo, Brazil. Individuals undergoing oncologic surgeries of the digestive system in the period of 08/01/2007 to 08/10/2008 were prospectively followed for 30 days after surgery. Possible risk factors related to the patient and to the surgical procedure were also studied. A total of 210 surgeries were analyzed, with a global SSI incidence of 23.8 percent. The following variables were independently associated with SSI: time and type of surgery, radiotherapy before surgery and surgeon's years of experience. The risk factors found in this study have been described by other authors and are not amenable to intervention for SSI prevention. Further studies are recommended with the objective of investigating interventions that could reduce the risk for SSI in this type of surgery.

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OBJECTIVES: This paper discusses the influence of a para-areolar incision in the upper outer quadrant of the breast on the location of the sentinel lymph node in a canine model. METHODS: The sentinel lymph node was marked with technetium-99, which was injected into the subareolar skin of the cranial breast. After the marker had migrated to the axilla, an arcuate para-areolar incision was performed 2 cm from the nipple in the upper outer quadrant. Patent blue dye was then injected above the upper border of the incision. At the marked site, an axillary incision was made, and the sentinel lymph node was identified by gamma probe and/or by direct visualization of the dye. The agreement between the two injection sites and the two sentinel lymph node identification methods was determined. Our sample group consisted of 40 cranial breasts of 23 adult females of the species Canis familiaris. The data were analyzed by using the McNemar test and by determining the kappa agreement coefficient. RESULT: Our findings showed that in 95 percent of the breasts, the sentinel lymph node was identified by the injection of technetium-99 m into the subareolar region, and in 82 percent of the cases, the sentinel lymph node was identified by the injection of patent blue dye above the upper border of the incision. The methods agreed 82 percent of the time. CONCLUSIONS: Previous para-areolar incisions in the upper outer quadrant did not interfere significantly with the biopsy when the dye was injected above the upper border of the incision.

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