Quality of life after videothoracic simpathectomy in patients with primary hyperhidrosisIntroduction: Primary hyperhidrosis is characterized by excessive sweating that exceeds the physiological needs to maintain thermal homeostasis of the body. This study aims to assess the change in quality of life of patients operated on videothoracoscopic sympathectomy. Materials and Methods: We included all patients operated with this technique in the period between 2004 and 2010, in FACh Hospital. A standardized cuestionary was used to measure severity of hyperhidrosis and quality of life during pre and postoperative. Results: 61 patients, 57% female and mean age of 25 years. Preoperative sweating was barely tolerable or unacceptable in 81%, and preoperative quality of life was poor or very poor in 82% of patients. After surgery sweating was never noticed or tolerable at 85% and the quality of life was better in 84% of patients. 78% of patients developed compensatory sweating; however the 87% were satisfi ed with the outcome of surgery. Conclusion: Videothoracoscopic sympathectomy offers excellent results that are measurable in terms of improvement of quality of life, but often associated with the phenomenon of compensatory sweating. Despite the development of this sequel, the majorities of operated patients are satisfi ed with the surgical results and improve their quality of life.
Concordance between the surgical piece observation by the surgeon and fi nal pathological report for gastric cancer Background: The systematic dissection of the surgical piece, performed by the surgeon during surgical treatment of gastric cancer, gives information about borders and lymph node involvement. Aim: To determine the concordance between the fi ndings of the surgeon during initial dissection and the fi nal pathological report. Material and Methods: Prospective study of 48 patients aged 64 ± 10 years (74% males) subjected to curative surgery for gastric cancer. Patients were staged according to 2010 TNM classifi cation. Stomach size from the lesser curvature, oral and caudal limits, macroscopic aspect, tumor diameter and lymph node involvement were determined by the surgeon observing the surgical piece. The concordance of this observation with the fi nal pathological report was assessed. Results: Fifty nine percent of patients were subjected to a total gastrectomy and there was a mean of 30 lymph nodes excised. There was a good concordance between surgeon observation and fi nal pathological report for tumor depth (Kappa = 0.64), macroscopic aspect (Kappa = 0.69) and tumor size (Lin = 0.84). There was a bad concordance for lymph node involvement (Kappa = 0.21). The percentage of retraction of lesser curvature length was 24%, 30% for oral and 22% for caudal limits. Conclusions: There is a good concordance between surgeon observation and pathological report for macroscopic aspect, tumor size and depth but the concordance for lymph node involvement is bad.
Los quistes hepáticos son una entidad frecuente y, en general, no dan manifestaciones clínicas. Sin embargo, algunos pacientes desarrollan síntomas derivados de la compresión de estructuras vecinas, distensión hepática o complicación de los quistes. Este grupo de enfermos requerirá tratamiento. Existen diversas opciones terapéuticas, siendo la alternativa quirúrgica la que presenta mejores resultados. Con el avance de las técnicas de cirugía mínimamente invasiva, la vía laparoscópica es de elección. Presentamos tres casos clínicos, el primero de un quiste hepático simple y los dos siguientes de enfermedad poliquística hepática, todos sintomáticos, en que la técnica de fenestración por vía laparoscópica se llevó a cabo con éxito.
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