Biomedical subjects

Jorge Ramón Lucena

Publications and source records attributed to Jorge Ramón Lucena.

3 recordsLinked to original sources

PubMed2005

[Laparoscopic versus mini-laparotomy cholecystectomy].

OBJECTIVES: To describe differences in operating time, pain scores, analgesic consumption, complications, length of hospital stay, and quality of life in laparoscopic cholecystectomy (LC) vs mini-laparotomy cholecystectomy (MLC). PATIENTS AND METHOD: Between 1991 and July 1999, we performed a study of 1041 patients with gallstones who underwent LC (group A, n = 421 patients) or MLC (group B, n = 620 patients). Age, sex, ASA score, pain scores (visual analog scale), analgesic and antiemetic consumption, operating time, complications and length of hospital stay were recorded. Nottingham Health Profile questionnaires were completed by a subgroup of 200 patients, and respiratory response was evaluated using a Fokuda spirometer before surgery and at 24 and 48 hours after surgery. Patient satisfaction and quality of life were evaluated. The results were interpreted using the SPSS program and descriptive statistics were performed with p = 0.05. RESULTS: The mean age was 48.9 +/- 14.2 years; 80.5% of the patients were women; 87.88% of the patients were ASA I. Elective surgery was performed in 89.78%. The mean operating time was 94 +/- 45 minutes in LC and was 108 +/- 48 minutes in MLC (p < 0.001). LC was associated with lower postoperative pain (0 = 68.88%), lower analgesic-antiemetic requirements (0 = 9.03%) and shorter length of hospital stay. Complications were significantly more frequent in group B (p = 0.05); two patients in group B died within 30 days of surgery (0.32%). CONCLUSIONS: LC appears to be associated with lower pain scores and analgesic-antiemetic requirements and shorter recovery times than MLC. The results in terms of quality of life in LC were excellent.

Adolescent↗

PubMed2005

[Thyroid carcinoma].

OBJECTIVES: To evaluate the results of surgical treatment in patients with thyroid carcinoma. MATERIAL AND METHOD: Eighty-five patients diagnosed with thyroid cancer between October 1970 and November 2004 were studied. Clinical presentation, diagnostic procedures, surgical treatment, histological diagnoses, complications and follow-up were analyzed. The information was processed using the BMDP statistical package. The results were analyzed using descriptive statistics: chi-square test and t-test to evaluate differences. Survival was analyzed using the Mantel-Cox test, with a value of P=0.05. RESULTS: Differentiated carcinoma was more frequent (usual variant in 84.5%; follicular carcinoma in 9.3% and tall cell carcinoma in 6.2%). Age: 48+/-5.48 years. Papillary carcinoma was diagnosed in younger patients than follicular carcinoma (p=0.03) and predominated in women aged less than 49 years. Symptoms were due to the presence of nodules in the neck, whether palpable or not. Seventy-four percent of nodules were non-echoic. Ultrasonography revealed the presence of a solitary nodule in 96%. Total thyroidectomy was performed in 82%, and hemi- or subtotal thyroidectomy was performed in 12%. Six percent of the patients received palliative treatment. Recurrence occurred in 6%. CONCLUSIONS: Mortality in thyroid carcinoma is related to histological type, age, sex, tumoral size, the presence of regional metastases and palliative treatment.

Adolescent↗

PubMed2005

[Resection of lung metastases from colorectal cancer].

OBJECTIVES: To evaluate clinically relevant prognostic factors and to define a subgroup of patients who would most benefit from resection of lung metastases. PATIENTS AND METHOD: Between July 1978 and April 2004, 125 patients with pulmonary metastases from colorectal cancer who underwent lung resections were prospectively followed-up. The median follow-up was 32.4 +/- 3.2 months. Patients with no evidence of extrathoracic recurrence, no more than three metastases on either side, and adequate cardiorespiratory function were eligible for surgery. The most frequent procedure was lobectomy. Univariate and multivariate analyses were performed, with a value of p = 0.05. RESULTS: A total of 54.4% of the patients were men. The median age was 53.04 +/- 11.5 years. Survival rates at 3 and 5 years were 47% and 27% respectively. The independent prognostic factors identified were size of metastases and extent of resection. Subgroup analysis defined two statistically relevant prognostic groups: patients with metastases sized 3.75 +/- 2.3 cm or less with a disease-free interval of more than 10 months and patients with larger metastases and a shorter disease-free interval. CONCLUSIONS: Subgroup analysis provided criteria for the selection of patients for resection of lung metastases from colorectal cancer and differentiated between those at high and low risk of early tumor progression.

Colorectal Neoplasms↗