SummaryArrhythmogenic right ventricular dysplasia, also called right ventricular cardiomyopathy, is a genetically determined heart muscle disease, characterised by life-threatening ventricular arrhythmias in apparently healthy young people. The primary myocardial pathology is that the myocardium of the right ventricular free wall is replaced by fibrous or fibrofatty tissue, with scattered residual myocardial cells. Right ventricular function is abnormal and in severe cases is associated with global right ventricular dilation and overt biventricular heart failure. Although still relatively rare, arrhythmogenic right ventricular cardiomyopathy is a well recognised cause of sudden unexpected peri-operative death. In this review, we describe the basic characteristics of this disease, emphasising the diagnosis and we offer some suggestions for the anaesthetic management of these patients in the peri-operative period.
SummaryHereditary angioedema is a rare genetic disorder resulting from an inherited deficiency or dysfunction of the C1-esterase inhibitor of the classic complement pathway. It is characterised by recurrent episodes of angioedema, without urticaria or pruritus, most often affecting the skin or the mucosal tissues of the upper respiratory and gastrointestinal tracts. We describe the peri-operative care of a woman with hereditary angioedema undergoing laparoscopic cholecystectomy with emphasis on the role of anaesthetists as peri-operative physicians.
<span style="font-family: Times New Roman; font-size: small;"> </span><p class="a"><strong><span>Background-Aims:</span></strong><span> Perioperative intraperitoneal chemotherapy either under normothermia during the early postoperative period (EPIC) or intraoperatively combined with heat (HIPEC) has been shown to improve survival after radical resection of advanced gastric cancer. The purpose of the study is to compare the effect of EPIC and HIPEC in patients undergoing D<sub>2</sub> gastrectomy for advanced gastric cancer.</span></p> <p class="a"><strong><span>Patients-Methods:</span></strong><span> Patients that received EPIC after D<sub>2</sub> gastrectomy were retrospectively compared to those that received HIPEC after D<sub>2</sub> gastrectomy. The end point of the study was the assessment of survival, and recurrences.</span></p> <p class="a"><strong><span>Results:</span></strong><span> The groups were comparable for age, gender, performance status, tumor anatomic distribution, stage, degree of differentiation, Lauren classification, hospital mortality, morbidity, and type of surgery. 5-year survival rate for HIPEC group was 68% and for EPIC group was 14% (<em>p</em>=0.0054).The recurrence rate in EPIC group was 57.9% and in HIPEC group 17.4% (<em>p</em>=0.001).</span></p> <p class="a"><strong><span>Conclusions: </span></strong><span>Patients with advanced gastric cancer undergoing D<sub>2</sub> gastrectomy in combination with HIPEC have improved survival and lower recurrence rate as compared to those undergoing D<sub>2</sub> gastrectomy in combination with EPIC.</span></p><p class="a"><strong><br /></strong></p><span style="font-family: Times New Roman; font-size: small;"> </span>
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