Publications (2)1.6 Total impact
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ABSTRACT: Introduction Introduction. Pericardial effusion is a clinical disease that requires multidisciplinary management. Several procedures have been described to perform a sufficient partial pericardiectomy in order to assure optimum drainage and that would also permit biopsy samples to be obtained. The purpose of this work is to evaluate the profitability of the partial pericardiectomy through video-assisted thoracoscopic surgery (VTS) in pericardial effusions with clinical suspicion of benignancy, evaluating its indications and its added value compared to other techniques. Material and methods We have performed pericardiectomies in 19 patients with clinical suspicions of benignancy using VTS. The indication was established due to the appearance of symptoms that could be attributed to effusion or when it was necessary to obtain samples. The presence of radiological and/or ultrasonographic signs of constrictive pericarditis or clinical instability were contraindications for the technique. Results The diagnosis after the pathology study was chronic inflammation in 6 cases, active tuberculosis (TBC) in 2 cases and uremic pericarditis in 4 more cases. Previously undiagnosed neoplastic etiology was established in 2 patients; in 5 cases, postsurgical effusions of cardiac surgery were drained. Conclusions VTS is an adequate technique for the diagnostic-therapeutic management of those undiagnosed pericardial effusions and in post-surgical ones. Its high diagnostic performance, low morbidity and almost null existence of relapses has made it especially indicated in cases where it is necessary to obtain samples and the foreseeable survival is long.Revista de Patología Respiratoria. 04/2009; 12(2):74–77.
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ABSTRACT: Surgeons have routinely removed ipsilateral axillary lymph nodes from women with breast cancer for over 100 years. The procedure provides important staging information, enhances regional control of the malignancy and may improve survival. As screening of breast cancer has increased, the mean size of newly diagnosed primary invasive breast cancers has steadily decreased and so has the number of women with lymph node metastases. Recognising that the therapeutic benefit of removing normal nodes may be low, alternatives to the routine level I/II axillary lymph node dissection have been sought. A decade ago sentinel lymph node biopsy (SLNB) was introduced. Because of its high accuracy and relatively low morbidity, this technique is now widely used to identify women with histologically involved nodes prior to the formal axillary node dissection. Specifically, SLNB has allowed surgeons to avoid a formal axillary lymph node biopsy in women with histologically uninvolved sentinel nodes, while identifying women with involved sentinel nodes who derive the most benefit from a completion axillary node dissection. Despite the increasing use of SLNB for initial management of the axilla in women with breast cancer, important questions remain regarding patient selection criteria and optimal surgical methods for performing the biopsy. This article discusses the evolution of axillary node surgery for women with breast cancer.Clinical and Translational Oncology 09/2007; 9(8):513-20. · 1.60 Impact Factor
Consorcio Hospital General Universitario de ValenciaValenza, Valencia, Spain