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Id: 155598
Autor: Reyes, Luis; García, Sergio; Torales, Jorge; Halperín, Irene; Alobid, Isam; Hanzu, Felicia; Mora, Mireia; Valero, Ricard; Enseñat, Joaquim.
Título: Cirugía endoscópica endonasal en patología selar. Análisis de nuestros primeros 200 pacientes. Qué hemos aprendido / Endoscopic endonasal surgery for sellar region pathology. An analysis of our first 200 patients. What we have learned
Fonte: Neurocirugía (Soc. Luso-Esp. Neurocir.);27(5):229-236, sept.-oct. 2016. graf, tab.
Idioma: es.
Resumo: Introducción: Los tumores hipofisarios y de la región selar representan el 10-15% de los tumores benignos intracraneales, siendo los adenomas los más frecuentes. En el siguiente artículo exponemos la experiencia adquirida a lo largo de 9años en el tratamiento quirúrgico por vía endoscópica de lesiones selares. Explicaremos los aspectos característicos de nuestra técnica quirúrgica y los resultados en términos clínicos y hormonales. Material y métodos: Realizamos un estudio retrospectivo de 200 pacientes con lesiones selares intervenidos por un único neurocirujano (J.E.) mediante abordaje endoscópico endonasal transesfenoidal entre febrero de 2006 y febrero 2015. No se incluyen abordajes extendidos a la base craneal, craneofaringiomas, ni lesiones inflamatorias, metastásicas o malignas. Resultados: De 200 pacientes, 7 eran quistes de Rathke y 193 adenomas (26 microadenomas y 165 macroadenomas). Subclasificados estos, a su vez, según el grado de invasión del seno cavernoso (Knosp 0, 1 y 2: 129 casos; Knosp 3 y 4: 71 casos). Se consiguió una exéresis tumoral completa en 143 pacientes (71,5%), subtotal en 39 (19,5%) y parcial en 18 (9%). En el grupo de mayor ocupación del seno cavernoso (Knosp 3 y 4) se consiguió una resección completa en un 55,5% (40/71). Se logró una remisión hormonal en 34 pacientes (85%) con acromegalia, en 23 (76%) con prolactinomas y en 30 (86%) con enfermedad de Cushing. Conclusión: Los resultados obtenidos en nuestra serie, fruto de la centralización y la experiencia, son equiparables a los mejores resultados conseguidos en centros de referencia de cirugía hipofisaria. La exploración quirúrgica precoz de la fístula reduce la tasa de meningitis posquirúrgicas (AU)

Introduction: Pituitary and sellar region tumours account for 10-15% of intracranial benign tumours, with pituitary adenoma being the most common one. In this article, a review is presented on 9 years of experience in surgical treatment using an endoscopic approach of sellar region lesions. The main features of our surgical technique will be explained, as well as the results in clinical and hormonal terms. Material and methods: A retrospective analysis was conducted on 200 patients operated on due to sellar lesions by the same neurosurgeon (J.E.) using an endoscopic endonasal transsphenoidal approach between February 2006 and February 2015. The cases excluded were, those requiring extended approaches of the skull base, as well as craniopharyngiomas, inflammatory, metastatic, or malignant lesions. Results: Of the 200 patients treated (59.5% women, mean age of 51.7 years, range: 18-82 years old), there were: 7 Rathke cysts and 193 adenomas (26 micro-adenomas and 165 macro-adenomas). All of them sub-classified according to the degree of invasion of the cavernous sinus (Knosp 0, 1, and 2: 129 cases and Knosp 3 and 4: 71 cases). Total resection was achieved in 143 patients (71.5%), subtotal resection in 39 (19.5%), and partial resection in 18 (9%). In the group of higher occupancy of the cavernous sinus (Knosp 3 and 4) complete resection was achieved in 55.5% (40 of 71 patients). Hormonal remission was achieved in 34 patients with acromegaly (85%), 23 patients with prolactinomas (76%), and 30 patients with Cushing's disease (86%). Conclusion: The results obtained in our series, due to the centralisation of pathology and experience, are comparable to those achieved in pituitary surgery reference centres. Early surgical exploration of cerebrospinal fluid leaks reduces the risk of post-surgical meningitis (AU)
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Texto completo SciELO Espanha
Id: 154143
Autor: Muñoz de Nova, José Luis; Viamontes Ugalde, Francisco Eduardo; Mendoza Jiménez-Ridruejo, Jorge.
Título: Resección endoscópica submucosa transanal (TASER) mediante sistema TEO / Transanal submucosal endoscopic resection (TASER) by TEO system
Fonte: Rev. esp. enferm. dig;108(7):444-445, jul. 2016. ilus.
Idioma: es.
Resumo: No disponible

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Id: 153490
Autor: Pericay, C; Serra-Aracil, X; Ocaña-Rojas, J; Mora-López, L; Dotor, E; Casalots, A; Pisa, A; Saigí, E.
Título: Further evidence for preoperative chemoradiotherapy and transanal endoscopic surgery (TEM) in T2-3s, N0, M0 rectal cancer
Fonte: Clin. transl. oncol. (Print);18(7):666-671, jul. 2016. tab, graf.
Idioma: en.
Resumo: Purpose Preoperative chemoradiotherapy and local excision via transanal endoscopic surgery (TEM) in T2û3s,N0,M0 rectal cancer achieve promising results in selected patients. We describe our long-term follow-up experience with this combination, and evaluate complete clinical and pathological responses, local recurrence and overall survival. Methods The prospective observational follow-up study carried out since 2007. Out of 476 consecutive patients treated with TEM, we selected those with adenocarcinoma of low or moderate grade of differentiation, clinical stages T2-superficial T3,N0,M0, who refused radical surgery. Preoperative chemoradiotherapy comprised 5-fluorouracil or capecitabine combined with radiotherapy at a dose of 50.4 Gy. TEM was performed after 8 weeks. Complications were recorded and long-term follow-up was conducted. Results Fifteen patients undergoing preoperative chemoradiotherapy and TEM (median age 76 years, 95 % CI 70.3û80.4, and median follow-up 38 months, 95 % CI 20û44) were studied. No local recurrence was observed, and only one patient (6.7 %) presented systemic relapse. The overall survival was 76 %. Complete clinical response was achieved in seven patients (46.7 %) and complete pathological response in four (26.7 %). With regard to toxicity associated with neoadjuvant treatment, four patients (26.7 %) developed grade 3 adverse effects; no grade 4 or 5 adverse effects were observed. There was no postoperative mortality. Conclusions The results of our study, with a response rate of 26.7 % and without local relapse, support the treatment of T2û3s,N0,M0 of rectal cancer with preoperative chemoradiotherapy and local excision (TEM) (AU)

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