PubMed Health⌕ Search

Biomedical subjects

G Malka

Publications and source records attributed to G Malka.

69 records · Page 4Linked to original sources
PubMedDate not supplied

Reducing the number of sentinel nodes removed in melanoma patients: a prospective study.

CONTEXT: Since 1992, sentinel lymph node (SLN) biopsy was generally applied to melanoma for tumor staging. As the literature points out, an increasing number of nodes are being removed for each procedure, driving up the cost for this procedure and wandering away from the defining concept of sentinel lymph node. AIMS: The objective of the current study was to show that the number of sentinel lymph node s removed can be minimized without influencing the reliability of tumor staging. MATERIALS AND METHODS: We conducted a single-arm prospective study in patients with stage I melanoma. For each patient, the sentinel lymph node was identified using the hand-held gamma probe technique. We removed only the hottest nodes as well as the nodes with radioactivity greater than 70% compared to the hottest. We analyzed the characteristics of each melanoma, the success rate of this procedure, how many nodes were removed and how many had micro metastases. STATISTICAL ANALYSIS: The results were compared to those of the literature, previously published Porter study using the chi-square test. RESULTS: We included 90 patients. The success rate of this technique was 100%. We dissected 1.3 sentinel lymph nodes for each patient, with 22% positive SLN. Statistical analyses point out a better selectivity of our study for a similar rate of pathological positivity and recurrence compared to the literature. CONCLUSIONS: Our technique for decreasing the number of sentinel lymph nodes removed is reliable. The removal of minimal number of nodes doesn't compromise the sensitivity of tumor staging, while it does reduce the cost of the procedure.

Adult↗
PubMedDate not supplied

[Reconstruction strategy in chest wall defect relating to the localization of the lost substances: retrospective study of 18 patients].

OBJECTIVE: To evaluate an original algorithm in function of the chest wall defect localization after large surgery for cancer including more than 3 ribs. PATIENTS AND METHODS: Our retrospective study on 18 patients (10 women, 8 men), operated by the senior author, showed 8 pathological tumor localization in the central chest region, 7 in the lateral region and 3 borderline localizations. For central localizations, when the sternum was resected, the reconstruction was realized with a Gore-tex mesh in depth, metal hooks (staples) and Marlex mesh under the musculocutaneous superficial coverage flap. Lateral localizations was done by a Gore-tex mesh covered by the musculocutaneous flap; the borderline localizations were covered by a Marlex mesh and superficial musculocutaneous flap. The superficial coverage flaps were performed by latissimus dorsi flaps in 16 cases and transversus rectus abdominis flap in 2 cases. RESULTS: All the patients were extubated and breathed spontaneously in the postoperative period. Two deaths and one infection were to regret at distance. No flap was lost. CONCLUSION: The algorithm of reconstruction according to the location of the defect allows a simplification of the indications.

Adolescent↗