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Biomedical subjects

A Sardi

Publications and source records attributed to A Sardi.

86 records · Page 5Linked to original sources
PubMedDate not supplied

Modified mandibular swing procedure for resection of carcinoma of the oropharynx.

For most patients, the primary approach to carcinoma of the oropharynx has been with radiotherapy. We describe a modification of a mandibular swing procedure for resection of oropharyngeal lesions. This modification included a mandibulotomy that began in a staircase manner in the midline and extended laterally toward the ramus of the mandible to protect a long, fixed dental bridge. It also included the preservation of the mental nerve by unroofing the mandibular canal. No morbidity was associated with this procedure.

Humans↗
PubMedDate not supplied

Multiple operations for recurrent colorectal cancer.

The benefit of an aggressive surgical approach in selective patients with recurrent colorectal cancer has been demonstrated by several investigators. The disease-free 5 year survival is 30%, and in carefully selected series it is as high as 46%. These procedures can be performed safely with minimal morbidity and mortality by surgeons who are experienced in the techniques of radical surgery. It is important and should be our focus to try to identify those patients who will benefit the most from an aggressive surgical approach, by better definition of the biology of the tumor through tumor differentiation and DNA and oncogene analysis.

Carcinoembryonic Antigen↗
PubMedDate not supplied

Hepatic resection at a community hospital.

Hepatic resection remains the "gold standard" in the primary management of primary and metastatic tumors to the liver. Advanced surgical techniques along with more modern and sophisticated equipment have led to an increasing number of hepatic resections being performed with a concomitant decrease in morbidity and mortality. We followed prospectively 18 consecutive hepatic resections performed over a period of approximately 2.5 years. The setting was a community teaching hospital with a low volume of referrals for hepatic resection. Sixteen (88%) had metastatic disease and two had primary liver disease. There were four trisegmentectomies, four lobectomies, four segmentectomies, and six large wedge re-sections. Average estimated blood loss was 608 ml. Seven patients required transfusions. Complications occurred in five patients (27%). In-hospital mortality was 0%. Our experience suggests that liver resections in a low-volume community hospital can be performed safely provided an experienced surgical team with familiarity of advanced surgical techniques and sophisticated equipment used in hepatic resection is readily available.

Adult↗
PubMedDate not supplied

Minimally invasive parathyroidectomy utilizing a gamma detecting probe intraoperatively.

The most common pathologic finding in primary hyperparathyroidism is a single adenoma. Traditionally, all four glands have been explored during surgery for primary hyperparathyroidism. With the advent of accurate localizing diagnostic studies, such as the sestamibi scan, some surgeons are now recommending single-gland exploration. In addition, when a sestamibi scan is performed the day of surgery, a gamma detecting probe can be used intraoperatively to direct the dissection. Although an experienced surgeon will successfully locate the abnormal gland 95% of the time with the traditional approach, this new technique results in a smaller incision with better cosmetic results as well as decreased operative time. Our initial experience with eight cases utilizing this technique is presented.

Humans↗
PubMedDate not supplied

Sentinel lymph node mapping for staging breast cancer: preliminary results of a prospective study.

Axillary lymph node dissection is the gold standard for staging breast cancer, but it is associated with significant morbidity and complications. Sentinel lymph node mapping technique has demonstrated a successful detection of the node or nodes more likely to have metastasis. Two techniques are being used to detect sentinel lymph node-intraoperative use of gamma detecting probe after injection of radio tracer preoperatively and the injection of blue dye and lymphatic mapping intraoperatively. We used both techniques. Twenty-four patients underwent sentinel lymph node mapping. Blue dye and gamma detecting probe identified sentinel lymph nodes in 78% and 77% of patients, respectively. Overall, 23 of 24 patients had a sentinel lymph node identified (96%). Ten patients had metastatic disease in the axilla. Out of these ten patients the only positive node/nodes were the sentinel lymph node in six patients. The other four patients had positive non-sentinel lymph node along with positive sentinel lymph node. All of the patients who had metastatic disease in the axilla were detected by the sentinel lymph node mapping technique. Therefore, no patient had positive non-sentinel lymph node if the sentinel lymph node was negative. This technique was 100% predictive of the axillary status. Sentinel lymph node mapping technique will change the management of breast cancer and will allow two-thirds of the patients with breast cancer to be managed without axillary lymph node dissection with a resulting reduction in morbidity and cost.

Axilla↗
PubMedDate not supplied

Management of cancer of the opposite breast following breast preservation.

Breast preservation has been shown to be a good alternative to mastectomy in selected patients with breast cancer. The purpose of this study was to evaluate the characteristics of cancer developing in the opposite breast to determine if breast preservation should be attempted in that breast as well. From 1979 to 1988, 172 women underwent tylectomy, axillary dissection and irradiation for carcinoma of the breast. All had follow-up mammogram. Mean age was 55 years. Mean follow-up time was 50 months. Thirteen patients (7.6%) developed cancer in the opposite breast. Three cancers were carcinoma in situ, nine were stage I, and one was stage IIa. Nine of 13 patients had breast preservation therapy, and four had mastectomies. Ten patients are alive with no evidence of disease, two are alive with disease and one died with disease. Breast preservation for bilateral breast cancer is a safe alternative if patients can be followed closely.

Adult↗
PubMedDate not supplied

Colostomy isolation during abdominal surgery.

Isolation of a colostomy during other abdominal operations could become burdensome or lead to contamination of operative site with feces. I present an effective, rapid, and safe technique that involves the placement of a purse string suture and colostomy packing in addition to external dressing.

Abdomen↗