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Biomedical subjects

A Redler

Publications and source records attributed to A Redler.

25 records · Page 2Linked to original sources
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[Thyroid nodules: comparison of preoperative and intraoperative needle aspirate and definite histological study].

The need to discover malignancy is the most challenging dilemma in the management of thyroid nodules, the most common endocrine disorders, affecting 4-5% of the general population. Malignancies account for only 2-3% of cases. The aim of our study was to evaluate the predictive value of preoperative fine-needle aspiration cytology (FNAC) in surgical decision making by evaluating the final pathologic diagnosis and comparing it to the preoperative and intraoperative diagnoses. We conducted a prospective study of 30 thyroid resections. The mean age was 49 years (range: 27 to 68 years). Preoperative physical and laboratory examinations, presenting symptoms, imaging studies and predictive values of preoperative and intraoperative FNAC were analyzed. The consistency of the lesion was strongly predictive of malignancy, when "hard". Single lesions were also predictive of malignancy. The diagnostic accuracy of preoperative FNAC vs intraoperative FNAC vs frozen section histopathology was 90% vs 100% vs 96.7%; sensitivity: 91.6% vs 100% vs 100%; specificity: 90.5% vs 100% vs 94.7%, while the positive predictive value was 84.6% vs 100% vs 91.7%, and the negative predictive value 95% vs 100% vs 100%. Ultrasound-guided preoperative FNAC showed high specificity, sensitivity and accuracy in diagnosing malignancy in thyroid nodules. Intraoperative FNAC was more accurate than intraoperative frozen sections in diagnosing malignancy in thyroid nodules.

Adult↗
PubMedDate not supplied

[Compatibility, indications, and limits of nerve sparing technique in lateral pelvic lymphadenectomy for advanced rectal carcinoma].

The aim of radical surgical treatment of rectal cancer is to control the spread and prevent recurrence of the disease. In an attempt to improve the results of treatment of locally advanced rectal cancer, we advocate an extended surgical approach consisting of total mesorectal excision, lateral pelvic lymphadenectomy and the nerve sparing technique with resection of autonomic nerves whenever these fibers are affected by locally advanced tumor. Nine cases (9.2%) in a personal series of 98 patients with rectal carcinoma, operated on over the period from January 1992 to December 1997, underwent total mesorectal excision, lateral pelvic lymphadenectomy and the nerve sparing technique procedures for locally advanced extraperitoneal disease. In 7 patients with stage II or III disease, the 5-year survival rate was 80% and the 5-year disease-free survival rate 66.7% after a mean follow-up of 55 months. None of them experienced local recurrence, but one patient died of diffuse metastatic disease 50 months after surgery. One patient with stage IV rectal cancer died of disease 13 months postoperatively, while another patient with the same stage of disease is still alive with disease 26 months after surgery. One patient underwent liver resection for a solitary metastasis 25 months after the primary operation. Two patients suffered postoperatively from urinary retention with mild irregular flow at urodynamic testing, but no long-term urinary disturbances persisted. Retrograde ejaculation occurred postoperatively in one of the two patients who experienced urinary disorders, and another patient had erection disturbances. These sexual dysfunctions did not improve during long-term follow-up. Total mesorectal excision, lateral pelvic lymphadenectomy, and the nerve sparing technique, with resection of the autonomic nerves whenever these fibers are involved, allow satisfactory results to be achieved in terms of survival and functional outcome in patients with locally advanced rectal cancer. In western subjects, however, this procedure is safe only after careful patient selection.

Adult↗