Biomedical subjects
Publications and source records attributed to R Canelo.
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Due to posterior location and the close relationship to vascular and biliary structures, resection of tumors within the caudate lobe of the liver may be a surgical challenge as well as an oncological hazard. Various approaches and techniques of isolated tumorectomy and combined liver resections are available and must be tailored to the individual situation. Prerequisite for a low operative risk is control of bleeding which can be achieved by sequential inflow and outflow occlusion of the liver.
The present study is based on the data of a homogeneous series of 736 women with stage I and II operable breast cancer. The same methodology was used for treatment and follow-up. Eighty-seven patients were under 40 and 649 between 40 and 70 years ols. No statistical difference was noted between the distribution in these 2 groups regarding tumor size, the axillary or internal mammary nodal status or hormonal receptor levels. Small tumors were noted more frequently in the under 40 yr group. Overall survival was the same in both groups, independently of tumor size, axillary nodal status or hormonal receptors. Disease-free survival differed between the 2 groups: local relapse risk was 1.6 times higher for women under 40 yr, in relation to a higher frequency of conservative treatment in this group. No difference was noted for DFS in relation a tumor size, axillary nodal status of hormonal receptors.
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We report on a case of bilateral subcapsular hematoma of the liver, occurring during treatment with warfarin. A 64-year-old woman was put on long-term warfarin therapy. After a bout of severe right hypochondriac pain, computed tomography (CT) scan showed subcapsular hematoma of the liver. Subsequent CT scan, conservative policy only, showed regression of the hematoma. The patient was discharged from the hospital on the 23rd day. We conclude that a nonruptured spontaneous liver hematoma should not be surgically removed. A conservative management with close observation is the mainstay therapy. A switch from warfarin therapy to another anticoagulation therapy is strongly suggested.