Biomedical subjects

H K Büchels

Publications and source records attributed to H K Büchels.

8 recordsLinked to original sources

PubMed2000

[Melanoma. Results with "sentinel node" sampling].

Since June 1995 we have practised a gamma probe guided sentinel lymphadenectomy (SLNE) in 274 patients after injecting a colloidal 99 m-Tc labelled solution around the tumor. By this technique the detection and excision of the SLN succeeded in 99.3% of all cases. We found micrometastases in about 53.1% of patients with pT3 and pT4 melanomas. The specimen of the radical lymph node dissection contained in 30% further metastases. A regional recurrence after SLNE occurred only in one case, a SLN-negative patient.

Adolescent↗

PubMed1999

[Sentinel lymph node detection by preoperative lymphoscintigraphy and intraoperative gamma probe guidance in malignant melanoma].

AIM: The purpose of this work was to prove the clinical significance of nuclear medical procedures in pre- and intraoperative detection of the SLN. METHODS: In the past 4 years, we did preoperative lymphoscintigraphy in 214 patients (pts.). Intraoperative localisation of the SLN with a hand-held gamma probe followed in 150 pts. RESULTS: In 214 pts. 247 lymphatic draining regions were found by preoperative scintigraphy. In 3 pts. with melanoma of the cheek no lymphatics/lymph nodes could be detected. 14 pts. showed interval lymph nodes. In 150 pts. gamma probe guided SLNE was done. In 2 pts. with supraclavicular primary tumor 4 SLN had been defined by preoperative scintigraphy but only 2 could be found intraoperatively. In all other cases (98.7%) the sentinel node was detected correctly by the gamma probe and then removed. In 19 of 150 pts. (12.7%) metastases were detected in the pathologic specimen. The incidence of lymph node metastases showed a continuous increase from 0% at tumor stage pT1 to 44% at stage pT4. CONCLUSION: SLNE is an accurate method to determine nodal involvement in melanoma and minimizes operative invasiveness in melanoma surgery.

Adolescent↗

PubMed1998

[Sentinel lymphadenectomy in malignant melanoma].

The sentinel lymph node dissection (SLND) is one of the most striking developments in the treatment of melanoma. Since the first report by Morton et al. in 1992, the method has been refined, and its use has increased. Introduced as an alternative to elective lymph node dissection (ELND), it has rapidly made its way into clinical practice. SLND allows precise pathologic staging through removal and analysis of a limited number of nodes (false-negative rate < 2%). It distinguishes patients with clinically occult nodal disease from those with tumor-free regional basin who would not benefit from radical dissection. However, the SLND is still an experimental procedure with yet unproven utility.

Humans↗

PubMed1998

[Sentinel lymph nodes in breast carcinoma].

Aim of the experiment is to select patients with positive axillary lymph nodes by means of the sentinel lymph node concept. In this way all other patients who would not benefit from a lymph node dissection are spared from this procedure and its morbidity. Till now the sentinel lymphadenectomy is, however, still an experimental technic with yet unproven utility.

Axilla↗

PubMed1998

[Surgical procedures in therapy of breast carcinoma with reference to the value of axillary endoscopy techniques].

During the last decades the surgical treatment of breast cancer has been dramatically changed. Today breast conservative treatment represents a therapeutic option applicable to nearly 70% of the women. In contrast to this, the technic of axillary dissection remained unchanged. Suzanne et al. proposed an axilloscopic technic to reduce this morbidity. The sometimes unacceptable low lymph node count in the specimen induced us to modify this procedure. In the future the sentinel lymph node concept perhaps offers the possibility to select NO-patients and to spare the axillary dissection completely to this sub-group.

Axilla↗

PubMed1997

[Scintillation probe guided sentinel lymphadenectomy in malignant melanoma].

In cutaneous melanoma, biopsy of the first tumor-draining lymph node (Sentinel node, SLN) may replace routine elective lymph node dissection (ELND). The SLN has been shown to contain the first micrometastasis in early lymphatic tumor dissemination. As micrometastases were identified in 10-30% of stage I (AJCC/UICC) patients, sentinel lymphonodectomy (SLND) should enable us to select patients clinically in stages I and II, but histopathologically in stage III. This optimization of patient selection is mandatory as only this subgroup profits from ELND. Since the beginning of 1995 we was scintillation detector (gamma probe)-guided sentinel biopsy in patients with a melanoma > 1.0 mm and clinically negative lymph nodes. After injecting colloidal 99m-Tc-labelled tin(II)-sulfide solution around the tumor (or the biopsy scar), the SLN can be localized exactly. The technique is minimally invasive and easy to handle. If the SLN contains tumor, a standard en bloc lymphonodectomy is performed. Long-term follow-up, however, is needed to delineate the role of this procedure in melanoma treatment.

Adult↗

PubMed1997

[Breast carcinoma staging with sentinel lymphadenectomy].

The objective of our trial was to evaluate the significance and usefulness of sentinel lymphadenectomy (SLNE) for the staging of regional lymph nodes in breast cancer patients. The study presented illustrates the method and our results. As has been documented for melanoma, the first lymph node [sentinel node (SLN)] to receive lymphatic drainage from a primary tumor is the expected first site of lymph-node metastasis. The database presented includes 12 patients with operable breast cancer and clinically negative lymph nodes. In 11 cases the described method was applicable. In only one case was there no correlation between the histology of the SLN and the axillary specimen. Three SLN were tumor-positive. Successful completion of examination of a large number of patients with a long follow-up has the potential of reducing the number of axillary dissections and of significantly reducing morbidity in the majority of breast cancer patients.

Aged↗

PubMed1997

[Surgical therapy of primary breast carcinoma--options and perspectives].

During the past quarter of the century the management of breast cancer has been dramatically influenced by new ideas and discoveries which, after being tested in controlled studies, govern current clinical practice. New therapeutic options are discussed, and first results are presented. The following procedures are illustrated: Van Nuys Classification of DCIS, skin-sparing mastectomy, stereotactic biopsy (ABBI), endoscopic axillary dissection, fluorescentic detection of positive lymph nodes, sentinel lymph nodes. Neoadjuvant chemotherapy, and menstrual cycle-dependent timing.

Breast Neoplasms↗