scholarly journals ACTUAL ISSUES OF ONCOPLASTIC ORGAN-PRESERVING SURGERY OF BREAST CANCER

2019 ◽  
Vol 178 (5) ◽  
pp. 36-46
Author(s):  
D. A. Ryabchicov ◽  
I. K. Vorotnikov ◽  
I. A. Dudina ◽  
A. M. Kazakov ◽  
D. A. Denchik

Surgical treatment of breast cancer (BC) has undergone significant changes over the past half century. Oncoplastic operations are a relatively new variant of organ-preserving surgical treatment of breast cancer. Its idea is to combine the principles of oncology and plastic surgery in order to obtain oncological safe and cosmetic acceptable results. Despite the widespread implementation of these operations, high-quality studies on the benefits of oncoplastic operations in comparison with other methods are not enough. Actual issues of breast cancer oncoplastic surgery was considered in this literature review, such as indications for surgery, classification of oncoplastic techniques, determination of positive resection margins, evaluation of recurrence and survival, postoperative complications, cosmetic result.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study (Conclusion of the local Ethics Committee at Northern State Medical University of 08.04.2015, Protocol No. 02/4-15). Author Guidelines contains the detailed information.

2018 ◽  
Vol 26 (8) ◽  
pp. 693-700
Author(s):  
Mafalda Trippel ◽  
Julia Slotta-Huspenina ◽  
Karen Becker ◽  
Tilman Rau ◽  
Stefan Paepke ◽  
...  

Introduction. The evaluation of the trimming surfaces (TS) of tissue blocks from frozen sections may serve as a supplementary examination tool for the intraoperative determination of resection margins of breast cancer specimens. This study aimed at the investigation of the feasibility and reliability of this technique, which has been described only very rarely in literature. Methods. Two observers assessed digital images from TS obtained from 57 resection margins. Findings were correlated with the diagnosis of the frozen section (FS) alone and the final diagnosis on formalin-fixed paraffin-embedded (FFPE) material. Results. The determination of the resection margin on TS was estimated as feasible for all cases. Interobserver congruence rate for TS was 96% (κ = 0.81), which was lower compared with FFPE (100%, κ = 1.0) but superior to FS (89%, κ = 0.67). Intraobserver congruence of the 2 reviewers was 96.5% and 93.0% between TS and FFPE, and 91.1% and 92.5% between FS and FFPE, respectively. The combination of both intraoperative consultation techniques showed similar congruence but a slight improvement for the sensitivity (0.75 to 0.875) for the diagnosis of tumor at the resection margin in FFPE for Reviewer 1 but was unchanged for Reviewer 2. Conclusion. The additional evaluation of TS can be a helpful additional tool for intraoperative margin assessment of breast cancer specimens, in particular, when processing artifacts of FS are encountered.


2021 ◽  
Vol 16 (1) ◽  
pp. 152-182
Author(s):  
Ahmad Arif Masdar Hilmy ◽  
Ria Cahyaning Utami

The determination of the dowry in the marriage of the people of Karangsono Village was originally based on the rules of Islamic law, namely by using the principles of convenience, lightness, and simplicity. However, people's lives that are never stagnant make them always interact with each other, thus forming a new concept of dowry determination in the community. The purpose of this article is to determine the description and implementation of the concept of the dowry class in the community marriage of Karangsono Village and to review it using the perspective of the social construction theory. This field research used a qualitative descriptive method and data analysis used Berger and Luckmann's social construction theory. Data were collected through document study, interviews, and observations. This research resulted in conclusions: (1) The concept of the dowry class in the community marriage of Karangsono Village is based on the classification of the prospective bride, which is seen from the status of a virgin or widow, her beauty, and age. The higher the quality of the woman, the higher the dowry she can get, (2) The determination of the dowry in Karangsono Village has undergone a social construction based on three simultaneous processes. The externalization process is illustrated through adaptation to religious texts and life being experienced. The process of objectivation here gives birth to new meanings, which are manifested in the actions of the wider community so that they become objective facts. The process of internalization is illustrated by the affirmation in the consciousness experienced subjectively.(Penentuan mahar dalam perkawinan masyarakat Desa Karangsono mulanya didasarkan pada aturan hukum Islam, yakni dengan menggunakan asas kemudahan, keringanan dan kesederhanaan. Namun kehidupan masyarakat yang tidak pernah stagnan, membuat mereka selalu berinteraksi satu sama lain, Tujuan artikel ini ialah untuk mengetahui deskripsi dan implementasi konsep kelas mahar dalam perkawinan masyarakat Desa Karangsono, serta ditinjau menggunakan perspektif teori konstruksi sosial. Penelitian lapangan ini menggunakan metode deskriptif kualitatif dan analisis datanya menggunakan teori konstruksi sosial Berger dan Luckmann. Pengambilan data dilakukan melalui studi dokumen, wawancara dan observasi. Penelitian ini menghasilkan beberapa kesimpulan: (1) Konsep kelas mahar dalam perkawinan masyarakat Desa Karangsono ialah berdasarkan klasifikasi yang dimiliki calon pengantin perempuan, yakni dilihat dari status perawan atau janda, paras kecantikan dan usianya. Semakin tinggi kualitas yang dimiliki perempuan, maka semakin tinggi pula mahar yang bisa didapatkannya, (2) Penentuan mahar di Desa Karangsono telah mengalami konstruksi sosial berdasarkan tiga proses simultan. Proses eksternalisasi tergambar melalui adaptasi dengan teks-teks keagamaan dan kehidupan yang sedang dialami. Proses objektivasi disini melahirkan pemaknaan baru, yang termanifestasikan ke dalam tindakan-tindakan masyarakat luas sehingga menjadi kenyataan objektif dan biasa dilakukan dalam kehidupan sehari-hari. Proses internalisasi tergambar oleh penegasan dalam kesadaran yang dialami secara subjektif dan pentransferan akan pengetahuan tentang makna-makna objektif)


2021 ◽  
Vol 20 (2) ◽  
pp. 118-126
Author(s):  
A. R. Bosieva ◽  
M. V. Ermoshchenkova ◽  
A. D. Zikiryakhodzhayev ◽  
N. N. Volchenko

Background. Neoadjuvant chemotherapy (NACT) is a standard of care for locally advanced breast cancer patients. One of the main advantages of NACT is the reduction of the tumor size and regression of lymph node metastasis.The aim of the study was to analyze the outcomes of breast-conserving surgery after NACT compared to adjuvant chemotherapy, including the examination of the width of resection margins and the frequency of re-operations, the volume of tissue removed and cosmetic outcomes.Material and Methods. We analyzed 1219 publications available from pubMed, Medline, Cochrane Library, 1057 of them did not meet the inclusion criteria, 162 publications were selected to cover all the following inclusion criteria: surgical margin status, frequency of re-operations, volume of tissue removed and cosmetic outcomes. Finally, 22 studies met fully specified criteria.Results. Studies included in this review demonstrated a different frequency of positive resection margins (2–39.8 %), reoperations (0–45.4 %), the volume of tissue removed (43.2–268 cm3), and the weight of the resected breast tissue (26.4–233 grams) after NACT.  Conclusion. The data obtained showed a decrease in the frequency of positive resection margins and re-operations in patients who received NACT compared to patients who did not receive NACT (5–39.8 % versus 13.1–46 % and 0–45.4 % versus 0–76.5 %, respectively), as well as a decrease in the amount of the removed breast tissue without the negative effect on the frequency of resection margins, thus allowing minimization of the extent of surgery and improvement of cosmetic outcomes.


Talanta ◽  
2021 ◽  
Vol 225 ◽  
pp. 122054
Author(s):  
Beatriz Arévalo ◽  
Amira ben Hassine ◽  
Alejandro Valverde ◽  
Verónica Serafín ◽  
Ana Montero-Calle ◽  
...  

2016 ◽  
Vol 4 (4) ◽  
pp. 6-11 ◽  
Author(s):  
Alexei G. Baindurashvili ◽  
Stanislav V. Ivanov ◽  
Vladimir M. Kenis

Background. Hip dislocation and subluxation are common in children with spina bifida.Aim. To determine the influence of the neurosegmental level on surgical treatment of hip dislocation and subluxation in children with spina bifida.Materials and methods. A total of 114 pediatric patients with spina bifida and hip dislocation and subluxation were treated at The Turner Scientific and Research Institute for Children’s Orthopedics (Saint Petersburg, Russia) from 2006 to 2015. The patients were divided into two groups according the Sharrard classification of neurosegmental lesions: a study group of 62 patients who underwent hip stabilization surgery and a control group of 52 patients who did not undergo hip stabilization procedures.Results. For patients with a high neurosegmental level (thoracic and L1-L2), surgical treatment for hip dislocation and subluxation, which included most cases (72%), led to motor deterioration (retrospective study). Of 40 patients with a neurosegmental level of L3-L4 and L5-S1, motor level improved in 13 (32.5%) but deteriorated in 10 (36%) of 28 patients in the control group.Conclusion. Determination of the neurosegmental level enables the prediction of motor level and reveals indication for surgical treatment.


Author(s):  
Jessie J. J. Gommers ◽  
Lucien E. M. Duijm ◽  
Peter Bult ◽  
Luc J. A. Strobbe ◽  
Toon P. Kuipers ◽  
...  

Abstract Background This study aimed to examine the association between preoperative magnetic resonance imaging (MRI) and surgical margin involvement, as well as to determine the factors associated with positive resection margins in screen-detected breast cancer patients undergoing breast-conserving surgery (BCS). Methods Breast cancer patients eligible for BCS and diagnosed after biennial screening mammography in the south of The Netherlands (2008–2017) were retrospectively included. Missing values were imputed and multivariable regression analyses were performed to analyze whether preoperative MRI was related to margin involvement after BCS, as well as to examine what factors were associated with positive resection margins, defined as more than focally (>4 mm) involved. Results Overall, 2483 patients with invasive breast cancer were enrolled, of whom 123 (5.0%) had more than focally involved resection margins. In multivariable regression analyses, preoperative MRI was associated with a reduced risk of positive resection margins after BCS (adjusted odds ratio [OR] 0.56, 95% confidence interval [CI] 0.33–0.96). Lobular histology (adjusted OR 2.86, 95% CI 1.68–4.87), large tumor size (per millimeter increase, adjusted OR 1.05, 95% CI 1.03–1.07), high (>75%) mammographic density (adjusted OR 3.61, 95% CI 1.07–12.12), and the presence of microcalcifications (adjusted OR 4.45, 95% CI 2.69–7.37) and architectural distortions (adjusted OR 1.85, 95% CI 1.01–3.40) were independently associated with positive resection margins after BCS. Conclusions Preoperative MRI was associated with lower risk of positive resection margins in patients with invasive breast cancer eligible for BCS using multivariable analysis. Furthermore, specific mammographic characteristics and tumor characteristics were independently associated with positive resection margins after BCS.


Author(s):  
MW Barentsz ◽  
EL Postma ◽  
T van Dalen ◽  
MA van den Bosch ◽  
M Hui ◽  
...  

2021 ◽  
Vol 27 (5) ◽  
pp. 610-619
Author(s):  
N.V. Zagorodny ◽  
◽  
A.I. Kolesnik ◽  
A.F. Lazarev ◽  
E.I. Solod ◽  
...  

Abstract. Introduction According to the overwhelming majority of Russian and foreign authors, orthopedic traumatologists have been striving to improve the results of surgical treatment of acetabular (AC) fractures over the past decades. First of all, this is due to an increase in the number and severity of this injury, persisting complications and dissatisfaction of researchers with their own results of surgical treatment. Purpose Study of the rationale used by traumatologists for certain surgical approaches in the treatment of acute acetabular fractures. Materials and methods Literature sources were searched for information in the systems and databases Pubmed, Embase, Scopus, Medline, Cochran Library, eLibrary, Wiley Online Library using the keywords: acetabular fractures, surgical treatment, acetabular approach, open reduction and fixation of acetabular fractures, duration and blood loss, hip arthroplasty. Results The incidence of AC fractures, according to different authors, ranges from 2 to 23.4 %. The cause of this injury is road traffic accidents in up to 83 % of all cases. A significant increase in the number of AC fractures was noted. AC fractures in the vast majority of cases are classified according to AO/ASIF. Displaced AC fractures and multiplanar fractures are subject to surgical treatment. Open reduction and internal fixation still remain the standard treatment for AC fractures. The choice of the surgical approach is carried out more often taking into account the classification of AC fractures, and the type of fracture dictates the choice of approach to the acetabulum. It was found that the authors are forced to use surgical approaches taking into account the fractures of the AC columns. Discussion Adherence of traumatologists to the standards regarding indications for the choice of surgical approaches for complex AC fractures was noted. Surgical approaches for the treatment of two-column acetabular fractures are still often extended and traumatic, prolonged and accompanied by blood loss. Conclusion In the surgical treatment of pelvic and AC fractures, most authors adhere to standards in the choice of approach and fixation of columns and AC fragments. There is unanimity in the recognition of the trauma and "expansion" of the approaches used, accompanied by blood loss reaching up to 2000 ml and more, and the duration of the operation is on average 3 hours 50 minutes. For the surgical treatment of acute AC fractures, the researchers used both classical and modified anterior and posterior surgical approaches with the obligatory consideration of the classification of AC fractures. The rationale for choosing an operative approach, as a rule, was the determination of the type of AC fracture according to the AO/ASIF classification. The most effective approach in the surgical treatment of AC fractures is the combined anterior and posterior approach.


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