(15 and 2.5%, respectively, p <0.001, for the former; 32.4 and 1.7%, respectively, p <0.001, for the latter). Conclusions: In this series, one third of microcarcinomas were multifocal and 10% had lymph node involvement. Therefore, the aggressiveness of these tumors is higher than what is reported in the literature and they should be treated with total thyroidectomy (Rev Méd Chile 2005; 133: 1305-10).
Primary hyperparathyroidism. Surgical treatment Background: Primary hyperparathyroidism (HPTP) is the most common cause of hypercalcaemia in the ambulatory setting. This condition affects between 0.1-2% of the population. Surgery is the only curative treatment. Objective: The aim of the study is to present our 10-year surgical experience. Methods: Analyticaldescriptive study. We included all patients diagnosed with HPTP treated with surgery in our hospital between June 2003 and June 2013. Results: 173 patients underwent surgery for HPTP. The mean age was 57.5 ± 13.5 years. Asymptomatic in 98 cases (56.6%). Resection the abnormal parathyroid glands was performed in all cases with intraoperative PTH monitoring. In 167 patients (96.5%) intraoperative PTH declined ≥ 50%. The median follow-up was 61 months (1-117 months). Cure was achieved in 169 patients (97.7%). Four cases (2.3%) had recurrence. Conclusions: Surgery is effective and safe for the treatment of HPTP. A decline in intraoperative PTH ≥ 50% predicts cure in 97.7% of cases.
new systemic therapies for melanoma Melanoma represents a disease with high tendency to metastasize locally, regionally to the lymph nodes, and systemically to lungs, liver, brain and bone. The surgical treatment has been the cornerstone to treat melanoma patients, with excellent results in early stage, but with poor effectiveness in advance disease with systemic metastases. Traditional chemotherapy with cytotoxic agents has shown little impact on stage IV patients, which has motivated new investigation and innovation in this field. During last 4 years, FDA has approved new therapies for the treatment of metastatic or unresectable melanoma, mostly based in immunotherapy and signal transduction inhibitors, with very promising results. The surgeons treating these patients must be updated about these new therapies, which represent a new treatment opportunity for our patients.
how and when to perform a skin biopsy of a pigmented lesion. What the surgeon need to knowAt present times, general surgeons are continuously faced to evaluate patients with pigmented lesions. Thus, is very important that surgeons acquire adequate knowledge not only to distinguish between suspicious lesion and non suspicious lesion, but also to correctly assess when and how to perform a skin biopsy. The early detection of melanoma and non melanoma skin cancer is one of the most important factors to achieve a better prognosis. The main objective of this article is to provide surgeons some tips and pitfalls to help accurate the evaluation and diagnosis of pigmented lesions. The authors also want to stress out the importance of the team work between surgeons and dermatologist, due that is well documented that multidisciplinary approach to skin cancer raises the possibilities of early diagnosis, adequate treatment and better results for patients with skin cancer. key words: Skin cancer, suspicious lesion, diagnosis, biopsy.
resumenEn la actualidad, el cirujano continuamente se ve enfrentado a evaluar distintos tipos de lesiones cutáneas en los pacientes, por lo que debe tener conocimientos de las características que hacen que una lesión sea sospechosa o no, para evaluar correctamente cuándo y cómo realizar una biopsia de una lesión cutánea. El diagnóstico precoz, tanto del melanoma como del cáncer de piel no melanoma, ha demostrado ser clave para mejorar el pronóstico de nuestros pacientes. Este artículo pretende entregar algunas claves para afinar Rev Chil Cir. Vol 67 -nº 5, Octubre 2015; pág. 538-544
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