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Barchi LC, Ramos MFKP, Dias AR, Forones NM, Carvalho MPD, Castro OAP, Kassab P, Costa-Júnior WLD, Weston AC, Zilberstein B, Ferraz ÁAB, ZeideCharruf A, Brandalise A, Silva AMD, Alves B, Marins CAM, Malheiros CA, Leite CV, Bresciani CJC, Szor D, Mucerino DR, Wohnrath DR, JirjossIlias E, Martins Filho ED, PinatelLopasso F, Coimbra FJF, Felippe FEC, Tomasisch FDS, Takeda FR, Ishak G, Laporte GA, Silva HJT, Cecconello I, Rodrigues JJG, Grande JCD, Lourenço LG, Motta LMD, Ferraz LR, Moreira LF, Lopes LR, Toneto MG, Mester M, Rodrigues MAG, Franciss MY, AdamiAndreollo N, Corletta OC, Yagi OK, Malafaia O, Assumpção PP, Savassi-Rocha PR, Colleoni Neto R, Oliveira RJD, AissarSallun RA, Weschenfelder R, Oliveira SCVD, Abreu TBD, Castria TBD, Ribeiro Junior U, Barra W, Freitas Júnior WRD. BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 2): UPDATE ON TREATMENT. Arq Bras Cir Dig 2021; 34:e1563. [PMID: 34008707 PMCID: PMC8121052 DOI: 10.1590/0102-672020210001e1563] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/09/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. AIM : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. METHODS To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. RESULTS : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. CONCLUSION : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.
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Affiliation(s)
- Leandro Cardoso Barchi
- Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Faculty of Medicine São Leopoldo Mandic, Campinas, SP, Brazil
| | | | - André Roncon Dias
- Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Paulo Kassab
- Department of Surgery, Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Wilson Luiz da Costa-Júnior
- Department of Abdominal Surgery, AC Camargo Cancer Center, São Paulo, SP, Brazil
- Department of Medicine, Baylor College of Medicine, Houston,Texas
| | | | - Bruno Zilberstein
- Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Faculty of Medicine São Leopoldo Mandic, Campinas, SP, Brazil
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Figueiredo Reis GM, Malheiros CA, Savassi-Rocha PR, Cançado Júnior OL, Thuler FR, Faria ML, Guerra Filho V. Gastric Emptying and Food Tolerance Following Banded and Non-banded Roux-en-Y Gastric Bypass. Obes Surg 2020; 29:560-568. [PMID: 30402805 DOI: 10.1007/s11695-018-3561-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Gastric emptying (GE) and food tolerance (FT) can be altered after Roux-en-Y gastric bypass (RYGB) has been performed, especially when it involved the use of a restrictive mechanism (such as a silastic ring). AIM To assess GE and FT in patients who underwent banded (BRYGB) or non-banded Roux-en-Y gastric bypass (RYGB). METHODS Forty-seven BRYGB patients and 47 RYGB patients underwent gastric emptying scintigraphy (GES) and FT assessment (by means of a questionnaire) between 6 months and 2 years postoperatively. RESULTS GES was performed on average 11.7 ± 5.0 months (6 to 24) postoperatively. T½ medians (time taken for the gastric radioactivity to decrease to half of the original value in the gastric pouch) in the RYGB and BRYGB groups were 48.7 min (40.6-183.0 min) and 56.3 min (41.1-390.9 min), respectively (p = 0.031). The median of total questionnaire scores was 24 points (18-27) in the RYGB group and 20 points (13-27) in the BRYBG group (p < 0.001). CONCLUSIONS The band (silastic ring) delays GE time and does not affect patient satisfaction or food tolerance to vegetables, bread, or rice, but does affect tolerance to the intake of meat, salad, and pasta. The best tolerated foods are vegetables, salad, and fish. Banded patients are more likely to regurgitate and vomit. Gastric emptying does not affect FT.
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Affiliation(s)
- Galzuinda Maria Figueiredo Reis
- Department of Surgery, Santa Casa of São Paulo Medical School, Rua Cesário Mota Jr, 61, São Paulo, SP, CEP 02112-020, Brazil. .,Department of Surgery, Santa Casa of Belo Horizonte, Av. Francisco Sales, 1111 - Santa Efigênia, Belo Horizonte, MG, CEP 30150-221, Brazil.
| | - Carlos Alberto Malheiros
- Department of Surgery, Santa Casa of São Paulo Medical School, Rua Cesário Mota Jr, 61, São Paulo, SP, CEP 02112-020, Brazil
| | - Paulo Roberto Savassi-Rocha
- Department of Surgery School of Medicine, Federal University of Minas Gerais (UFMG), Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG, CEP 30130-100, Brazil
| | - Omar Lopes Cançado Júnior
- Department of Surgery, Santa Casa of Belo Horizonte, Av. Francisco Sales, 1111 - Santa Efigênia, Belo Horizonte, MG, CEP 30150-221, Brazil
| | - Fábio Rodrigues Thuler
- Department of Surgery, Santa Casa of São Paulo Medical School, Rua Cesário Mota Jr, 61, São Paulo, SP, CEP 02112-020, Brazil
| | - Mauro Lima Faria
- Department of Surgery, Santa Casa of Belo Horizonte, Av. Francisco Sales, 1111 - Santa Efigênia, Belo Horizonte, MG, CEP 30150-221, Brazil
| | - Vicente Guerra Filho
- Department of Surgery School of Medicine, Federal University of Minas Gerais (UFMG), Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG, CEP 30130-100, Brazil
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Barchi LC, Ramos MFKP, Yagi OK, Mucerino DR, Bresciani CJC, Ribeiro JÚnior U, Andreollo NA, AssumpÇÃo PP, Weston AC, Colleoni Neto R, Zilberstein B, Ferraz ÁAB, Charruf AZ, Dias AR, Brandalise A, Silva AMD, Alves B, Malheiros CA, Marins CAM, Leite CV, Szor D, Wohnrath DR, Ilias EJ, Martins Filho ED, Lopasso FP, Coimbra FJF, Felippe FEC, Tomasisch FDS, Takeda FR, Ishak G, Laporte GA, Silva HJT, Cecconello I, Rodrigues JJG, Grande JCD, Lourenço LG, Motta LMD, Ferraz LR, Moreira LF, Lopes LR, Toneto MG, Mester M, Rodrigues MAG, Carvalho MPD, Franciss MY, Forones NM, Corletta OC, Castro OAP, Malafaia O, Kassab P, Savassi-Rocha PR, Oliveira RJD, Sallun RAA, Weschenfelder R, Oliveira SCVD, Abreu TBD, Castria TBD, Barra W, Costa Júnior WLD, Freitas Júnior WRD. BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 1): AN UPDATE ON DIAGNOSIS, STAGING, ENDOSCOPIC TREATMENT AND FOLLOW-UP. Arq Bras Cir Dig 2020; 33:e1535. [PMID: 33331431 PMCID: PMC7747489 DOI: 10.1590/0102-672020200003e1535] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. AIM To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. METHODS To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. RESULTS Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. CONCLUSION The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice.
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Affiliation(s)
- Leandro Cardoso Barchi
- Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Faculty of Medicine São Leopoldo Mandic, Campinas, SP, Brazil
| | | | - Osmar Kenji Yagi
- Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Donato Roberto Mucerino
- Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | - Ulysses Ribeiro JÚnior
- Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Ramiro Colleoni Neto
- Department of Surgery, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Bruno Zilberstein
- Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Faculty of Medicine São Leopoldo Mandic, Campinas, SP, Brazil
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Rodrigues JBSR, Campanati RG, Nolasco F, Bernardes AM, Sanches SRDA, Savassi-Rocha PR. PRE-OPERATIVE GASTRIC GIST DOWNSIZING: THE IMPORTANCE OF NEOADJUVANT THERAPY. ACTA ACUST UNITED AC 2019; 32:e1427. [PMID: 30758475 PMCID: PMC6368167 DOI: 10.1590/0102-672020180001e1427] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/07/2018] [Indexed: 01/26/2023]
Abstract
Introduction: Gastric gastrointestinal tumors (GIST) are a rare and usually asymptomatic neoplasm that can present as abdominal mass in more advanced scenarios. Since surgical resection is the main aspect of the treatment, locally advanced tumors require multivisceral resection and, therefore, higher postoperative morbidity and mortality. Objective: To perform a review the literature on the topic, with emphasis on the neoadjuvant therapy. Methods: Literature review on the Medline database using the following descriptors: gastrointestinal stromal tumors, neoadjuvant therapy, imatinib mesylate and molecular targeted therapy. Results: Surgical resection remains the cornerstone for the treatment of GISTs; however, tyrosine kinase inhibitors have improved survival as an adjuvant therapy. More recently, neoadjuvant therapy have been described in the treatment of locally advanced tumors in order to avoid multivisceral resection. Conclusion: Despite surgical resection remains as the most important aspect of the treatment of GISTs, adjuvant and neoadjuvant therapy with tyrosine kinase inhibitors have shown to both improve survival and resectability, respectively.
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Affiliation(s)
| | - Renato Gomes Campanati
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, MG, Brazil
| | - Francisco Nolasco
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, MG, Brazil
| | - Athos Miranda Bernardes
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, MG, Brazil
| | | | - Paulo Roberto Savassi-Rocha
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Alfa Institute of Gastroenterology, Belo Horizonte, MG, Brazil
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Sousa AA, Porcaro-Salles JM, Soares JMA, Meyer de Moraes G, Souza Silva G, Abreu Sepulcri R, Rezende Carvalho J, Savassi-Rocha PR. Tolerance of early oral feeding in patients subjected to total laryngectomy. Head Neck 2015; 38 Suppl 1:E643-8. [DOI: 10.1002/hed.24063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 02/09/2015] [Accepted: 03/27/2015] [Indexed: 11/07/2022] Open
Affiliation(s)
- Alexandre Andrade Sousa
- Department of Head and Neck Surgery; Universidade Federal de Minas Gerais, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | | | - João Marcos Arantes Soares
- Department of Head and Neck Surgery; Universidade Federal de Minas Gerais, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | - Gustavo Meyer de Moraes
- Department of Head and Neck Surgery; Universidade Federal de Minas Gerais, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | - Guilherme Souza Silva
- Department of Head and Neck Surgery; Universidade Federal de Minas Gerais, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | - Rafael Abreu Sepulcri
- Department of Head and Neck Surgery; Universidade Federal de Minas Gerais, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | - Jomar Rezende Carvalho
- Department of Head and Neck Surgery; Universidade Federal de Minas Gerais, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
| | - Paulo Roberto Savassi-Rocha
- Department of Head and Neck Surgery; Universidade Federal de Minas Gerais, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais; Belo Horizonte Minas Gerais Brazil
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Sousa ADA, Porcaro-Salles JM, Soares JMA, de Moraes GM, Carvalho JR, Silva GS, Savassi-Rocha PR. Predictors of salivary fistula after total laryngectomy. Rev Col Bras Cir 2014; 40:98-103. [PMID: 23752634 DOI: 10.1590/s0100-69912013000200003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 08/07/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the incidence of pharyngocutaneous fistula after total laryngectomy and try to identify its predictors. METHODS From May 2005 to April 2010, 93 patients underwent total laryngectomy. We evaluated complications during and after surgery and compared them with the following variables: gender, nutritional status, previous tracheotomy, tumor location, type of surgery, TNM staging, prior treatment with chemotherapy and/or radiotherapy, use of flaps for reconstruction and surgical margin. All patients presented with advanced neoplastic disease according to TNM. RESULTS 14 (15.1%) patients developed postoperative salivary fistula. The mean time to onset of salivary fistula was 3.5 days, with a standard deviation of 13.7 days. Comparing salivary fistula with TNM variables, type of operation and neck dissection, prior tracheotomy, use of flap, preoperative radio and chemotherapy and surgical margin, there was no statistically significant difference (p> 0,05). CONCLUSION The incidence of salivary fistula was 15.1% and no predictive factor for its formation was found.
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Sousa AA, Porcaro-Salles JM, Soares JMA, de Moraes GM, Silva GS, Sepulcri RA, Savassi-Rocha PR. Does early oral feeding increase the likelihood of salivary fistula after total laryngectomy? J Laryngol Otol 2014; 128:1-7. [PMID: 24736040 DOI: 10.1017/s0022215114000747] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: This study compared the incidence of salivary fistula between groups with an early or late reintroduction of oral feeding, and identified the predictive factors for salivary fistula. Methods: A randomised trial was performed using 89 patients with larynx or hypopharynx cancer, assigned to 2 groups (early or late). In the early group, oral feeding was started 24 hours after total laryngectomy or total pharyngolaryngectomy, and in the late group, it was started from post-operative day 7 onwards. The occurrence of salivary fistula was evaluated in relation to the following variables: early or late oral feeding, nutritional status, cancer stage, surgery performed, and type of neck dissection. Results: The incidence of salivary fistula was 27.3 per cent (n = 12) in the early group and 13.3 per cent (n = 6) in the late group (p = 0.10). The following variables were not statistically significant: nutritional status (p = 0.45); tumour location (p = 0.37); type of surgery (p = 0.91) and type of neck dissection (p = 0.62). A significant difference (p = 0.02) between the free margins and invasive carcinoma was observed. Conclusion: The early reintroduction of oral feeding in total laryngectomised patients did not increase the incidence of salivary fistula.
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Affiliation(s)
- A A Sousa
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - J M Porcaro-Salles
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - J M A Soares
- Department of Medicine, Universidade Federal de São João Del Rei, Divinópolis, Minas Gerais, Brazil
| | - G M de Moraes
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - G S Silva
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - R A Sepulcri
- Department of Medicine, Universidade Federal de São João Del Rei, Divinópolis, Minas Gerais, Brazil
| | - P R Savassi-Rocha
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Albuquerque W, Arantes VN, Coelho LGV, Dias CAF, Savassi-Rocha PR. Complementation by argon plasma coagulation after endoscopic piecemeal resection of large colorectal adenomas. Rev Col Bras Cir 2014; 40:404-8. [PMID: 24573590 DOI: 10.1590/s0100-69912013000500010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 11/07/2012] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of complement by argon plasma coagulation to reduce the rate of residual or recurrent tumor after complete endoscopic piecemeal resection of large sessile colorectal adenomas. METHODS INCLUSION CRITERIA patients with large sessile colorectal adenomas (e" 20 mm), without morphological signs of deep infiltration, submitted to complete endoscopic piecemeal resection studied with chromoendoscopy and magnification of images. Patients were randomized into two groups: group 1 - no additional procedure, and group 2 - complementation by argon plasma coagulation. follow-up colonoscopy was performed at three, six and 12 months postoperatively. We evaluated the rate of local recurrence or residual malignancy. RESULTS The study included 21 patients, eleven in group 1 and ten in group 2. There were two local recurrences or residual tumors in each group, detected at three months follow-up. CONCLUSION Complementation by argon plasma coagulation after apparent complete endoscopic piecemeal resection of large sessile colorectal adenomas does not seem to reduce the occurrence of residual adenomatous lesions or local recurrence.
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Sousa MTDD, Savassi-Rocha PR, Cabral MMDÁ. Impact of using a lymph node revealing solution in surgical specimens for pathological staging of gastric cancer. Jornal Brasileiro de Patologia e Medicina Laboratorial 2014. [DOI: 10.5935/1676-2444.20140055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Seabra ALR, Savassi-Rocha PR, Vasconcelos AC, Lima AS, Rodrigues KCL, Almeida HMD. Ischemia/reperfusion injury after continuous or intermittent hepatic pedicle clamping in rabbits. Arq Bras Cir Dig 2013; 25:105-9. [PMID: 23381753 DOI: 10.1590/s0102-67202012000200009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 03/13/2012] [Indexed: 01/03/2023]
Abstract
BACKGROUND The control of bleeding in hepatectomy is a challenge for surgeons. The hepatic pedicle clamping is a surgical maneuver that can provide reduction in bleeding, but it provokes a hepatocellular suffering. This, along with reperfusion after the clamping finishes, leads to an injury known as ischemia/reperfusion injury. AIM To examine the effects of the ischemia/reperfusion injury on the liver after continuous and intermittent hepatic pedicle clamping in an animal model, using the quantification of apoptosis for evaluation. METHOD Twenty New Zealand rabbits were assigned to groups 1 (control), 2 (60 minutes of continuous ischemia) and 3 (60 minutes of intermittent ischemia alternating 12 minutes of ischemia and three minutes of reperfusion). Liver biopsies were collected before ischemia, at its end and after six hours of reperfusion, when the animals were killed. The liver fragments were subjected to histological analysis (paraffinization and hematoxilin-eosin staining) and histochemical (Tunel reaction). Microscope fields of view were scanned for characterization and quantification of apoptosis. RESULTS Ischemia led to an increased apoptotic index in both experimental groups in comparison to controls, but similarly between them. After the reperfusion, the indexes returned to baseline values. CONCLUSION Clamping of the hepatic pedicle, either continuous or intermittent, induces apoptosis in liver cells in a similar way.
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Sousa ADA, Salles JMP, Soares JMA, Moraes GMD, Carvalho JR, Savassi-Rocha PR. Fatores preditores para hipocalcemia pós-tireoidectomia. Rev Col Bras Cir 2012; 39:476-82. [DOI: 10.1590/s0100-69912012000600006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 07/06/2012] [Indexed: 01/05/2023] Open
Abstract
OBJETIVO: Avaliar a incidência e os fatores preditores da hipocalcemia e hipoparatireodismo definitivo pós-tireoidectomia. MÉTODOS: Foi dosado cálcio iônico no pré e no pós-operatório (primeiro, segundo e 30ºdia) em 333 pacientes submetidos à tireoidectomia. Naqueles que apresentaram hipocalcemia, as dosagens foram feitas também aos 90 e 180 dias de pós-operatório, quando se dosou também o paratormônio. Os pacientes foram agrupados segundo a presença ou ausência de hipocalcemia e avaliados segundo idade, sexo, função tireoidiana, volume tireoidiano, número de paratireoides identificadas e necessidade de reimplante de paratireoides, tipo de operação, tempo operatório e diagnóstico histopatológico. RESULTADOS: A incidência de hipocalcemia temporária foi de 40,8% (136 pacientes), e hipoparatireoidismo definitivo de 4,2% (14 pacientes). Tireoidectomia total ou reoperação, esvaziamento cervical, hipertireoidismo, tempo operatório e idade acima de 50 anos foram fatores determinantes de incidência significativamente maior de hipocalcemia e hipoparatireodismo definitivo (p<0,05). CONCLUSÃO: os fatores preditores da hipocalcemia pós-operatória incluem idade (>50 anos), tireoidectomia total, reoperação, esvaziamento cervical e tempo operatório. Os fatores preditores do hipoparatireoidismo definitivo pós-tireoidectomia incluíram tipo de operação, diagnóstico histológico e hipertireoidismo.
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Araújo JGC, Mota LDG, Leite EA, Maroni LDC, Wainstein AJA, Coelho LGV, Savassi-Rocha PR, Pereira MT, de Carvalho AT, Cardoso VN, De Oliveira MC. Biodistribution and antitumoral effect of long-circulating and pH-sensitive liposomal cisplatin administered in Ehrlich tumor-bearing mice. Exp Biol Med (Maywood) 2011; 236:808-15. [DOI: 10.1258/ebm.2011.011038] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cisplatin (CDDP) is one of the most active cytotoxic agents and has been widely used in the treatment of peritoneal carcinomatosis by the intraperitoneal (i.p.) route. However, CDDP, a low-molecular-weight compound, is rapidly absorbed by the capillaries in the i.p. serosa and transferred to the bloodstream, inducing the appearance of systemic side-effects, such as nephrotoxicity. Furthermore, the i.p. CDDP chemotherapy is limited to patients whose residual tumor nodules are less than 0.5 cm in diameter after surgical debulking. The failure of i.p. therapy is attributed to the poor penetration of CDDP into larger tumors. One strategy to improve drug delivery in the peritoneal region and reduce toxicity is the use of drug delivery systems. The objective of the present work was to evaluate the biodistribution and antitumoral effect of long-circulating and pH-sensitive liposomes containing CDDP (SpHL-CDDP), as compared with free CDDP, after their i.p. administration in Ehrlich ascitic tumor-bearing mice. After administering a 6 mg/kg single i.p. bolus injection of either free CDDP or SpHL-CDDP, ascitic fluid (AF), blood and organs (kidneys, liver, spleen and lungs) were collected and analyzed for CDDP content. The area under the CDDP concentration–time curve (AUC) obtained for AF and blood after SpHL-CDDP administration was 3.3-fold larger and 1.3-fold lower, respectively, when compared with free CDDP treatment, thus indicating its high retention within the peritoneal cavity. The determination of the ratio between AUC in each tissue and that in blood (Kp) showed a lower accumulation of CDDP in kidneys after SpHL-CDDP treatment. The SpHL-CDDP treatment demonstrated a significant uptake by the liver and spleen. SpHL-CDDP treatment led to a higher survival rate of mice with initial or disseminated peritoneal carcinomatosis than CDDP treatment. These results indicate that SpHL-CDDP may be useful for i.p. chemotherapy due to their greater concentration in the peritoneal cavity.
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Affiliation(s)
| | - Luciene das Graças Mota
- Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte
| | - Elaine Amaral Leite
- Departamento de Produtos Farmacêuticos
- Departametno de Farmácia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, 39100-000 Diamantina
| | - Laís de Carvalho Maroni
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Centro de Pesquisas René Rachou/FIOCRUZ, Av. Augusto de Lima, 1715, 30190-002 Belo Horizonte
| | - Alberto Julius Alves Wainstein
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100 Belo Horizonte
| | - Luiz Gonzaga Vaz Coelho
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100 Belo Horizonte
| | - Paulo Roberto Savassi-Rocha
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100 Belo Horizonte
| | - Márcio Tadeu Pereira
- Centro de Desenvolvimento de Tecnologia Nuclear (CDTN)/Comissão Nacional de Energia Nuclear (CNEN), Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais, Brazil
| | - Andréa Teixeira de Carvalho
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Centro de Pesquisas René Rachou/FIOCRUZ, Av. Augusto de Lima, 1715, 30190-002 Belo Horizonte
| | - Valbert Nascimento Cardoso
- Departamento de Análises Clínicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte
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Sousa ADA, Salles JMP, Soares JMA, Moraes GMD, Carvalho JR, Savassi-Rocha PR. Evolution of blood magnesium and phosphorus ion levels following thyroidectomy and correlation with total calcium values. SAO PAULO MED J 2010; 128:268-71. [PMID: 21181066 PMCID: PMC10948054 DOI: 10.1590/s1516-31802010000500005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 07/26/2009] [Accepted: 09/16/2010] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE magnesium ion concentration is directly related and phosphorus ion concentration is inversely related to calcemia. The aim of this study was to evaluate the evolution of magnesium and phosphorus ion levels in patients undergoing thyroidectomy and correlate these with changes to calcium concentration. DESIGN AND SETTING prospective study at the Alpha Institute of Gastroenterology, Hospital das Clínicas, Universidade Federal de Minas Gerais. METHODS the study included 333 patients, of both genders and mean age 45 ± 15 years, who underwent thyroidectomy between 2000 and 2005. Total calcium, phosphorus and magnesium were measured in the blood preoperatively and 24 and 48 hours postoperatively. Ionic changes were evaluated according to the presence or absence of postoperative hypocalcemia. RESULTS there were statistically significant drops in blood phosphorus levels 24 and 48 hours after thyroidectomy, compared with preoperative values, in the patients without hypocalcemia. In the patients who developed hypocalcemia, there was a significant drop in plasma phosphorus on the first postoperative day and an increase (also statistically significant) on the second day, in relation to preoperative phosphorus levels. A significant drop in postoperative magnesium was also observed on the first and second days after thyroidectomy in the patients with hypocalcemia, in relation to preoperative levels. In the patients without hypocalcemia, the drop in magnesium was significant on the first day, but there was no difference on the second day. CONCLUSION despite the postoperative changes, neither magnesium nor phosphorus ion levels had any role in post-thyroidectomy calcemia.
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Affiliation(s)
- Alexandre de Andrade Sousa
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Savassi-Rocha AL, Diniz MTC, Savassi-Rocha PR, Ferreira JT, Rodrigues de Almeida Sanches S, Diniz MDFHS, Gomes de Barros H, Fonseca IK. Influence of Jejunoileal and Common Limb Length on Weight Loss Following Roux-en-Y Gastric Bypass. Obes Surg 2008; 18:1364-8. [DOI: 10.1007/s11695-008-9475-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Accepted: 02/15/2008] [Indexed: 10/22/2022]
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Vignolo MC, Savassi-Rocha PR, Coelho LGV, Soares MP, Cardoso-Júnior A, Barbosa TFL, Ramos FV, Alves TR, Barbosa GM, Pinto DCG, Resende CDC, Boechat LDC, de Almeida AM. Gastric emptying before and after cholecystectomy in patients with cholecystolithiasis. Hepatogastroenterology 2008; 55:850-854. [PMID: 18705281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND/AIMS The objective of the present study was to measure gastric emptying time of solids and semisolids in dyspeptic individuals with cholecystolithiasis before and 6 months after cholecystectomy in order to determine whether cholecystectomy interferes with gastric emptying. METHODOLOGY A prospective, self-pairing study was conducted on 29 patients selected according to appropriate inclusion and exclusion criteria. Gastric emptying time of solids and semisolids was determined before and six months after laparoscopic cholecystectomy by the 13C-octanoic acid and 13C-acetate breath tests, respectively. The samples were analyzed by infrared spectrometry. The gastric retention time (lag phase) and gastric emptying half-time of solid and semisolid were determined and the results obtained before and after surgery were compared in the same patient. In addition, the effects of surgery on dyspeptic symptoms were assessed. RESULTS No significant differences (p>0.05) in gastric retention time and gastric emptying half-time of solid and semisolid test meals were observed before and after cholecystectomy. Dyspeptic symptoms (pain, upper abdominal gases, early satiety, nausea and vomiting) improved after surgery. CONCLUSIONS Laparoscopic cholecystectomy does not interfere with the gastric emptying time of solids or semisolids in dyspeptic individuals with cholecystolithiasis.
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Affiliation(s)
- Maria Cristina Vignolo
- Alfa Institute of Gastroenterology, University Hospital, Faculty of Medicine Federal University of Minas Gerais, Belo Horizonte, Brazil
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Reis GMF, Savassi-Rocha PR, Nogueira AMMF, Lima MJR, de Carvalho S, Arantes V, Barros CA, Cançado OL. Histological Esophagitis Before and After Surgical Treatment of Morbid Obesity (Capella Technique): A Prospective Study. Obes Surg 2008; 18:367-70. [DOI: 10.1007/s11695-008-9447-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2007] [Accepted: 01/22/2008] [Indexed: 10/22/2022]
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Cardoso-Júnior A, Coelho LGV, Savassi-Rocha PR, Vignolo MC, Abrantes MM, de Almeida AM, Dias EE, Vieira G, de Castro MM, Lemos YV. Gastric emptying of solids and semi-solids in morbidly obese and non-obese subjects: an assessment using the 13C-octanoic acid and 13C-acetic acid breath tests. Obes Surg 2007; 17:236-41. [PMID: 17476878 DOI: 10.1007/s11695-007-9031-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND It has been suggested that obesity is associated with an altered rate of gastric emptying. The objective of the present study was to determine whether the rates of solid and semi-solid gastric emptying differ between morbidly obese patients and lean subjects. METHODS The Gastric-emptying time (GET) of solid and semi-solid meals were compared between lean healthy subjects and morbidly obese patients enrolled in two previously published studies. GET of solid and semi-solid meals was measured using the 13C-octanoic acid breath test and 13C-acetic acid breath test, respectively, in 24 lean and 14 morbidly obese individuals of both sexes. Student t-test was used to compare the mean data between the lean and morbidly obese groups. The influence of sex, gender, BMI and morbid obesity on the GET of solid meals was verified by linear regression analysis. RESULTS Mean t(1/2) values of solid GET (+/- standard deviation) were 203.6 +/- 76.0 min and 143.5 +/- 19.1 min for lean and obese subjects, respectively (P = 0.0010). Mean t(lag) values of solid GET were 127.3 +/- 42.7 min and 98.4 +/- 13.0 min for lean and obese subjects, respectively (P = -0.0044). No significant difference in semi-solid GET was observed between the lean and morbidly obese groups. CONCLUSION The present study demonstrated a significantly enhanced gastric emptying of the solid meal test in morbidly obese patients when compared to lean subjects. This finding is compatible with the hypothesis that rapid gastric emptying in morbidly obese subjects increases caloric intake due to a more rapid loss of satiety.
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Affiliation(s)
- Aloísio Cardoso-Júnior
- Alfa Institute of Gastroenterology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
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18
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Júnior AC, Savassi-Rocha PR, Coelho LGV, Spósito MMDM, Albuquerque W, Diniz MTC, Paixão ADM, Garcia FD, Lasmar LF. Botulinum A toxin injected into the gastric wall for the treatment of class III obesity: a pilot study. Obes Surg 2006; 16:335-43. [PMID: 16545166 DOI: 10.1381/096089206776116408] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Obesity represents a major public health problem in western countries. Initial studies suggest that injection of botulinum A toxin (Btx-A) into the antropyloric region inhibits propulsive contractions of the antral pump, with delay in gastric emptying, early satiety and weight loss. METHODS After approval by the University Ethics Committee, we prospectively evaluated 12 patients with class III obesity divided into 4 groups of 3 patients each. In groups I and II, 200 U Btx-A were injected into the antropyloric region at 8 and 16 sites, respectively. Groups III and IV received 300 U Btx-A into the antropyloric region at 16 and 24 sites, respectively. Body weight and gastric emptying time (GET) of solids and semi-solids using 13C-octanoic acid breath test and 13C-acetic acid breath test, respectively, were determined before and after injection over a period of 12 weeks. RESULTS Pre- and post-treatment body weight or solid and semi-solid GET did not differ significantly between groups (P>0.05). All patients reported a feeling of early satiety. No adverse effects related to BtxA or complications resulting from the endoscopic procedure were observed. CONCLUSION The injection of different doses of BtxA at different sites in the antropyloric region of patients with class III obesity did not interfere significantly with the solid and semi-solid GET or body weight of these individuals. However, early satiety was reported by all patients, the procedure was safe and no side-effects of the treatment were observed. Further controlled studies involving different methodologies regarding dosage of Btx-A and sites of injection are necessary.
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Affiliation(s)
- Aloísio Cardoso Júnior
- Alfa Institute of Gastroenterology, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Savassi-Rocha PR, Almeida SR, Sanches MD, Andrade MAC, Frerreira JT, Diniz MTC, Rocha ALS. Iatrogenic bile duct injuries. Surg Endosc 2003; 17:1356-61. [PMID: 12811663 DOI: 10.1007/s00464-002-8726-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2002] [Accepted: 01/09/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND The real incidence of bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is not known. METHODS Using questionnaires, we analyzed 91,232 LC performed by 170 surgical units in Brazil between 1990 and 1997. RESULTS A total of 167 BDI occurred (0.18%); the most frequent were Bismuth type 1 injuries (67.7%). Most injuries (56.8%) occurred at the hands of surgeons who had surpassed the learning curve (50 operations). However, the incidence dropped with increasing experience; it was 0.77% at surgical departments with <50 operations vs 0.16% at departments with >500 operations. The diagnosis was made intraoperatively in 67.7%, but it was based on intraoperative cholangiography in only 19.5%. The procedure was converted to open surgery in 85.8% when the diagnosis of injury occurred intraoperatively, and laparotomy was performed in 90.7% when the injury was diagnosed postoperatively. The mean hospitalization time was 7.6 +/- 5.9 days, the major complications were stenosis and fistulas, and the mortality rate was 4.2%. CONCLUSION The incidence of BDI after LC is similar to that reported for the open procedure. BDI increases mortality and morbidity and prolongs hospitalization; therefore, all efforts should be made to reduce its incidence.
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Affiliation(s)
- P R Savassi-Rocha
- Alfa Institute of Gastroenterology, University Hospital, Federal University of Minas Gerais, 110 Alfredo Balena Ave., Belo Horizonte, MG, 30.220-260, Brazil.
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Savassi-Rocha PR, Sanches MD. [Cholecystectomy in cirrhotic patients: open or laparoscopic?]. Arq Gastroenterol 2002; 39:209-11. [PMID: 12870078 DOI: 10.1590/s0004-28032002000400001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Savassi-Rocha PR, Veloso LF. Treatment of superior mesenteric artery embolism with a fibrinolytic agent: case report and literature review. Hepatogastroenterology 2002; 49:1307-10. [PMID: 12239932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Successful treatment of superior mesenteric artery embolism depends on an aggressive approach in patients at risk for mesenteric ischemia. This approach favors an early diagnosis and permits the reestablishment of arterial flow within an appropriate time, with prevention of vasospasm and control of organic insufficiencies. We report here a case of superior mesenteric artery embolism in which arterial flow was reestablished by selective intra-arterial infusion of streptokinase. The literature has reported 18 similar cases thus far. This procedure could be an alternative to embolectomy in selected patients, i.e., patients with an early diagnosis, no evidence of intestinal necrosis and with partial occlusion and/or occlusion of secondary branches of the superior mesenteric artery. Frequent arteriographies and intensive care are necessary in this approach. The patient should be continuously monitored because of the possibility of treatment failure and the need for embolectomy.
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Affiliation(s)
- Paulo Roberto Savassi-Rocha
- Service of Gastroenterology, Nutrition and Surgery of the Digestive Apparatus (GEN-CAD), University Hospital, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Pereira WA, Savassi-Rocha PR, Cinqualbre J, Wolf P. Early diagnosis of small bowel allografts rejection by Doppler ultrasound fluxometry. Transplant Proc 2002; 34:525-6. [PMID: 12009612 DOI: 10.1016/s0041-1345(02)02617-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Savassi-Rocha PR, Ferreira JT, Diniz MT, Sanches SR. Laparoscopic cholecystectomy in Brazil: analysis of 33,563 cases. Int Surg 1997; 82:208-13. [PMID: 9331856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The authors present the results obtained in 33,563 laparoscopic cholecystectomies performed in Brazil from 1990 to 1995. Data were obtained by mailing questionnaires to 220 Services, 118 of which responded. The features included the year when the service started its activities, patient distribution by sex and age, surgical indications, prophylaxis with antibiotics, use of nasogastric and vesical catheters, technique used to produce pneumoperitoneum, intraoperative cholangiography, management of choledocholithiasis, necessity and causes of conversion to open surgery, surgical time, intra and postoperative complications, time of hospitalization, mortality, patient return to normal activities, and laparoscopic cholecystectomy in pregnancy. Analysis of the results demonstrated that the data are equivalent to those obtained in leading world countries and at times even better in terms of lesion of the main bile duct, time of hospitalization, etc.
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Affiliation(s)
- P R Savassi-Rocha
- Gastroenterology, Nutrition, General and Digestive Surgery Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Savassi-Rocha PR, Conceicão SA, Ferreira JT, Diniz MT, Campos IC, Fernandes VA, Garavini D, Castro LP. Evaluation of the routine use of the nasogastric tube in digestive operation by a prospective controlled study. Surg Gynecol Obstet 1992; 174:317-20. [PMID: 1553612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This prospective, randomized controlled trial was undertaken to evaluate the effect of tube decompression of the stomach after surgical procedure on the digestive tract. One hundred and nine patients were randomly allocated to postoperative treatment with (57 patients) or without (52 patients) nasogastric tubes. No significant differences were found between the two groups in the duration of hospitalization, time to begin peroral fluid intake, occurrence of hiccups, vomiting, nausea, parotiditis, nasal septum necrosis, anastomotic leak and wound dehiscence. Moreover, abdominal distension, pyrosis, otalgia, dysphagia, odynophagia and atelectasis occurred more often in intubated patients as shown by chi-square analysis of the data with Yates correction, with the level of significance at p = less than 0.05. Tube decompression of the stomach does not relieve intestinal paralysis after digestive operations. These data seem to indicate that the routine prophylactic use of a nasogastric tube is unnecessary in gastrointestinal operations.
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Affiliation(s)
- P R Savassi-Rocha
- Gastroenterology, Nutrition and Digestive Surgery Unit, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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