COMPLICACIONES DE MASTECTOMIA RADICAL PDF

A systematic review of the literature with a pooled analysis of 12, procedures. Currently, there is scarce information about this disorder, especially with regard to the etiology. The oncological safety of nipple-sparing mastectomy: Treatment is directed to inhibit thyroid hormone synthesis with carbimazole during months. Thyroid disturbances have a unique association with IIH. Laparotomia exploratoria javier florez castano academia.

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Se analizan las complicaciones, que se desglosan en los siguientes apartados: 1. Infecciones de la herida. Lesiones nerviosas. Las lesiones del nervio del serrato mayor, las del dorsal ancho y las del plexo braquial son las principales.

Generalmente, son poco frecuentes pero pueden producirse secuelas importantes. Lesiones pleurales. Hemos de tenerlas siempre en cuenta y pueden ser de gran trascendencia si el cirujano que opera la mama no sabe resolverlas.

Lesiones vasculares. Pueden ser muy graves cuando afectan a la vena y a la arteria axilar. Ap The present study presents and enumerates the different complications which may arise in breast surgery. Firstly, a description is given of the topographical anatomic characteristics that the surgeon must keep in mind when operating in this region so as to avoid lesions which may give rise to later complications.

This study incorporates the experience of our unit in breast surgery during the last three years and which we cite after the description of each complication. The complications have been broken-down into the following groups. Hemorrhage: the high risk of this complication due to the rich vascularization of the gland and operating on areas of difficult hemostasis is described. With regard to our statistics, we had hemorrhaging in 5. Only one case necessitated re-intervention for hemostasis of the bleeding vain.

Surgical wound infections: technical and medical prophylactic measures used to prevent such infections are described.

When infection has occurred the type of surgical or conservative measure employed in treatment is indicated. In our statistics for conservative surgery we showed 9. Surgery of non-palpable lesions: this is a difficult, high risk surgery carried out in very small areas.

Among the complications that occurred in our unit there were 2. Nerve lesions: injuries to the nerves of the brachial plexus, the latissimus dorsi and the serratus anterior are the major lesions occurring in breast surgery. These are generally infrequent but can cause significant side effects. We showed 7. Multiple lesions: the possibility of multiple injury must always be born in mind.

These can lead to significant complications if the surgeon operating on the breast does not know how to resolve them. We had no instances of multiple lesions in our case history. Lymphedema: this complication is less and less frequent as surgery respects one or both pectoral muscles. Additionally, after complete lymphadenectomy this area does not normally receive radiation.

We had 4. All were cured with medical treatment. Lymphorrhage: this is frequent after lymphadenectomy and normally resolves with drainage and compression.

We showed Vascular lesions: these may be serious when they affect the axillary vein and artery. Rapid and effective resolution is necessary. We had no lesions of this type within our statistics.

Cutaneous lesions: these appear on the underside of the arm after axillary lymphadenectomy. They diminish spontaneously in a short time and are treated with symptomatic medication.

Foreign bodies: the appearance of foreign bodies is not infrequent and is often due to the leaving of material in the operating area or to suture rejection. These generally expulse spontaneously via fistula but sometimes require re-intervention. La hemostasia en cada paso debe ser meticulosa, para poder ver y no actuar nunca a ciegas. Suele estar mezclada con sangre. Terminaremos dejando un drenaje tipo tejadillo, que se exteriorice por dicha abertura.

Lesiones nerviosas Estas complicaciones pueden ser temporales o definitivas. El plexo nervioso de la axila inerva todo el miembro superior. Todos los casos han curado o mejorado notablemente con medidas rehabilitadoras. Lesiones vasculares Se deben a heridas de los vasos arteriales o venosos axilares. La trombosis es otra de las complicaciones que pueden aparecer, generalmente por contusiones vasculares y traumatismos originados por las valvas y separadores en unos casos u otras veces por ligaduras venosas que obstruyen total o parcialmente la luz del vaso.

Pensar en estos acontecimientos y operar adecuadamente constituye la mejor profilaxis. En general, si actuamos correctamente, estas lesiones no tiene mayor importancia Aumentan los costes y las estancias de los pacientes alargando el postoperatorio y retardando el alta hospitalaria. Correspondencia: Dr.

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