Biomedical subjects

L Barutta

Publications and source records attributed to L Barutta.

3 recordsLinked to original sources

PubMed2005

Axillary recurrence after negative sentinel lymph node biopsy without axillary dissection: a study on 479 breast cancer patients.

AIMS: To determine the axillary recurrence rate in breast cancer patients with negative sentinel lymph nodes (SLN) who did not undergo further axillary lymph node dissection (ALND), and to establish whether this conservative axillary approach leads to an increased recourse to diagnostic axillary biopsy during the follow-up period because of the clinical suspicion of nodal recurrence. METHODS: In 479 patients, operated on for early breast cancer between 1998 and 2002 in five institutions, SLN biopsy was negative and no further axillary surgery was performed. SLN was localized using subdermal injection with 30-50 MBq of 99m-Tc-colloidal albumin. Follow-up controls were performed at 6-monthly intervals. RESULTS: The mean number of SLNs removed was 1.4 per patient. Most patients (90.6%) were given adjuvant systemic therapy, based on the primary tumour characteristics. At a median follow-up of 35.8 months, no clinical axillary recurrence was found. No patient underwent surgical axillary biopsy for suspicious clinical or ultrasonographic findings. CONCLUSIONS: Our results confirm that SLN biopsy without ALND in SLN-negative patients with early breast cancer is not followed by clinically evident axillary recurrence in the short-term.

Adult↗

PubMedDate not supplied

[Substernal goiter: a diagnostic and therapeutic problem. (Report of 39 surgically treated cases)].

Substernal goiter is a rare pathology and its definition varied from author to author. We considered substernal the goiter that has the larger diameter below the thoracic inlet, in accord to definition of Valdoni (1957). The authors examined retrospectively 40 cases of endothoracic goiter, that represent 6.1% of patients operated on thyroid. Surgical access was in 35 cases a cervical collar incision; in 2 patients was necessary to associate a median superior sternotomy and in another patient a lateral thoracotomy. In 3 patients the access was a median sternotomy and in the last patient a posterolaterally thoracotomy. The authors carried out 12 total thyroidectomy (30.7%), 15 subtotal thyroidectomy (38.6%), 10 total lobectomy (25.6%), 2 subtotal lobectomy (5.1%). No mortality was observed. The morbility was represented by 5 monolateral temporary palsy of recurrent laringeal nerve, 6 transitory hypocalcemia, 1 tetanic syndrome, 1 transitory arrhythmy. The follow-up was managed on 35 patients (89.7%). We observed 1 definitive hypoparathyroidism, 1 paralysis of recurrent laringeal nerve, 1 mediastinic relapse. One patient was operated on total thyroidectomy 14 years after the first surgery for a differentiated carcinoma. In conclusion the treatment of substernal goiter is surgical. Debating point is the entity of exeresis. We think that the first choice operation is thyroidectomy, done through a cervical collar incision. Occasionally sternotomy or thoractomy are necessary.

Female↗

PubMedDate not supplied

[Treatment of chronic pancreatitis today: considerations on 133 observed cases].

Aim of the work is to define the present role of surgery in the treatment of chronic pancreatitis and the criteria of choice of procedures. The authors examined retrospectively 133 patients. They analyze the clinical, laboratory and instrumental features on which has been formulated the surgical indications. Patients treated surgically were those who have intractable pain, jaundice, intestinal obstructions and bleeding. The choice of the procedure is based on the seat and type of the anatomo-pathological lesions and on the features of Wirsung's duct. 54 of the 133 patients observed have been treated surgically or with interventional radiology. The authors carried out 19 resections, 30 drainage procedures, 1 pancreatic biopsy, 2 percutaneous drainage, 1 perendoscopic papillotomy. Neither mortality nor morbidity were observed after radiological and endoscopic procedures, while after surgery we observed 3.9% of mortality and 9.4 of total morbidity and 5.6% of specific morbidity, represented by a pancreatic leakage. The long term results were well in the patients who didn't take on alcohol. In conclusion the authors underline that the progresses of the medical treatment and the radiological and endoscopic procedures imply the decrease of number of patients undergoing surgical intervention. They remind that surgery maintain his importance and, when carried out with correct indications, permits to obtain an effective and lasting result of the symptomatology presented by the patient.

Adult↗