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Biomedical subjects

José Manuel Ramia

Publications and source records attributed to José Manuel Ramia.

7 recordsLinked to original sources
PubMed2006

[Hepatocarcinoma in noncirrhotic liver].

Hepatocellular carcinoma (HCC) usually develops in patients with liver cirrhosis or chronic liver disease. These tumors are highly infrequent in patients without precipitating factors. We present a series of four patients with nonfibrolamellar HCC arising in healthy liver. None of the patients had viral infection, or showed alcohol abuse and/or hemochromatosis. Three patients underwent surgery. The clinical characteristics, therapeutic options, and survival and recurrence rates in this type of tumor are discussed.

Adult↗
PubMed2005

[Distal pancreatectomy: one technique with several indications].

INTRODUCTION: Distal pancreatectomy (DP) is performed for various pancreatic processes. This procedure has become less frequent since it ceased to be systematically used in oncologic gastric surgery and it is now performed mainly in patients with chronic pancreatitis. We present a series of patients who underwent DP and discuss technical features and surgical indications. PATIENTS AND METHODS: We performed a retrospective study of patients who underwent classical DP with associated splenectomy (CIE: 52.52) in our service from 1998-2003. Fourteen DP were performed during the study period. RESULTS: The mean age was 52.6 years. Thirty-six percent of the patients were male (5/14). Diagnosis was mucinous cystic tumor of the pancreas (5), neuroendocrine tumor (3), focal chronic pancreatitis (2), pancreatic cancer (2), pancreatic injury due to a sharp instrument wound (1), and pancreatic metastases from renal cancer (1). The most frequently used diagnostic procedure was abdominal computerized axial tomography (13/14). Surgery was elective in 86%. The technique used to close the distal stump was manual suture (29%), mechanical stapling (64%) and suture plus stapling (7%). No statistically significant relationship was observed between closure of the stump and the development of pancreatic fistula. Morbidity was 35% and mortality was 0%. The mean length of hospital stay was 18 days. CONCLUSIONS: DP can be performed without mortality but morbidity is not inconsiderable and is usually associated with the development of pancreatic fistulas. The indications for DP have changed and currently this procedure is performed for several pancreatic processes that are becoming increasingly frequent.

Adult↗
PubMed2005

[Benign solid liver tumors].

Benign solid liver tumors are a heterogeneous group of lesions (adenoma, focal nodular hyperplasia, hemangioma, etc.) with highly varied epidemiological characteristics. Advances in diagnostic methods have improved preoperative diagnosis. Magnetic resonance imaging has become the key test, but there is still a percentage of cases in which definitive preoperative diagnosis is not feasible. The most frequent symptom is abdominal pain, although patients are frequently asymptomatic. Surgery is indicated when diagnosis is uncertain or there are complications (rupture, hemorrhage, etc.). Because of the risk of malignant transformation, adenomas should always be resected. Morbidity and mortality after resection of these tumors is very low since excision is limited, performed in young people without concomitant disease, and in healthy liver.

Adenoma↗
PubMed2005

[Surgical treatment of liver metastases from breast cancer].

INTRODUCTION: A small number of patients with breast cancer develop liver metastases (LM) as the sole site of regional dissemination. In these patients, surgical resection seems to be the best therapeutic option. We present our experience of LM from breast cancer and discuss the indications for resection. MATERIAL AND METHODS: Between July 2003 and March 2005, we performed five hepatectomies for LM from breast cancer. The mean age was 51 years (range: 38-66). Patients received diverse combinations of chemotherapy, hormone therapy and radiotherapy after mastectomy. The disease-free interval between mastectomy and diagnosis of LM was 61 months (range: 36-80). The number of LM was 1.83 (range: 1-6) with a median of one LM. The mean size was 4.1 cm (range: 1.5-6). RESULTS: Surgery consisted of segmentectomy (three patients), bisegmentectomy (one patient), right hepatectomy associated with isolated metasectomies of the left lobe and hilar lymphadenectomy (one patient). Operative mortality was 0%. Morbidity was 20% (one patient). The mean length of hospital stay was 8 days. The mean length of follow-up was 11.4 months (range: 3-21). The mean survival was 11.4 months (range: 3-21). Disease-free survival was 9.6 months (range: 3-21). Two patients have had recurrence (one local and one regional). CONCLUSIONS: Given its characteristics, LM from breast cancer is an infrequent indication for liver resection and should be performed whenever technically feasible, whenever R0 resection can be achieved, and when there is low operative risk. Postoperative survival is better with resection than with any other therapeutic modality, even though the period of disease-free survival is short.

Adult↗