BackgroundOxidized regenerated cellulose polymer (ORCP) may be used for reshaping and filling lack of volume in breast-conserving surgery (BCS). The study aimed to observe both the aesthetic and diagnostic outcomes in patients with different age, BMI, breast volume, and breast tissue composition over 36 months after BCS with ORCP.Patients and methods18 patients with early breast cancer and with proliferative benign lesions underwent BCS with ORCP that was layered in three-dimensional wafer, and placed into the Chassaignac space between the mammary gland and the fascia of pectoralis major with no fixation. After surgery, patients started a clinical and instrumental 36-month follow-up with mammography, ultrasonography, magnetic resonance imaging (MRI) and cytological examination with fine needle aspiration when seroma occurred.ResultsBelow the median age of 66 years old no complications were observed even in case both of overweight, and large breasts with low density. Over the median age seromas occurred with either small or large skin retraction, with the exception of 1 patient having quite dense breasts and low BMI, which had no complications. In elderly patients, 1 case with quite dense breasts and high BMI showed severe seroma and skin retraction, while 1 case with low BMI and less dense breasts highlighted milder complications.ConclusionDuring 36 months after BCS with ORCP, a significant correlation between positive diagnostic and aesthetic outcomes and low age, dense breasts, and low BMI of patient was observed. Despite of the few number of cases, either low BMI, or high breast density improved the aesthetic outcomes and reduced the entity of complications even in the elderly patients.
The procedure for prolapsed hemorrhoids (PPH) is associated with low levels of postoperative pain but may be followed by unusual and severe postoperative complications.We report a case of a 62-year-old woman affected by tenesmus, obstructed defecation and vaginal bulging 2 years after a PPH procedure performed in another institution. Clinical examination and colonoscopy revealed a mass within the anterior rectal wall bulging into the vaginal and rectum lumen 3 cm above the dental line, mimicking a stromal tumor.Magnetic resonance imaging (MRI) confirmed the presence of an avascular mass, 4 cm in diameter, confined to the anterior rectal wall (Figs. 1, 2).Intraoperative findings revealed a calcified fecaloma enclosed in a mucousal rectal diverticulum communicating with the rectal lumen with a little opening at the level of the staple line (Figs. 3, 4).
This study stems from the need to provide the breast surgeon with a decision support system (DSS) along with information on tracers able to reduce the likelihood of failure due to Langer axillary arch (LAA) ( Figure 1A-C) in sentinel lymph node (SLN) biopsy (SLNB) and axillary lymph node dissection (ALND, lymphadenectomy). 1-7 The 99m Tc-nanocolloidal albumin 8 Nanocoll® (TcLC) at particle size range 3-80 nm with a total dose of 200 µCi and intradermal 0.2-0.3 mL injection was compared with indocyanine green 9 (ICG) injected at 1.0 mL and used to guide dissection of lymph nodes (LNs) in the dark after 2.0-3.0 minutes of breast massage. Histological examination of LNs permitted to classify breast cancers subtypes, 10 while statistics outlined significant data at an α level below 0.05.In the within of 440 breast cancers collected in 12 years and retrospectively analyzed according to guidelines, 10 74 were not candidates to axillary surgery, while the remaining 366 undergone or to ALNDs with primary breast procedure, or solely to SLNB, or to secondary ALND (Table 1). Most of the patients were in postmenopausal status with the majority of primary pT1/pT2 tumors and ductal type cancers which were distributed in molecular subtypes as follows: 38% of Luminal A, 29% of Luminal B, and 20% of HER2 positive. In the only-SLNB group and when ALND completed the SLNB, the values of collected and metastatic LNs were comparable between TcLC and ICG in line with other studies. 8,9A 2.7% occurrence of LAA (10 cases out of the 366 axillae- Table 2) placed the incidence of such muscular variation in the bottom of detection range in clinical procedures.
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