Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery最新文献

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PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS. 口周内窥镜肌切开术治疗贲门失弛缓症:94 名患者的安全状况、并发症和治疗效果。
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-12-08 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230066e1784
Francisco Paulo Ponte Prado Junior, Ivens Filizola Soares Machado, Maria Paula Lopes Ponte Prado, Renato Bruno Cavalcante Leite, Samuel Magalhães Gurgel, José Walter Feitosa Gomes, José Huygens Parente Garcia
{"title":"PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS.","authors":"Francisco Paulo Ponte Prado Junior, Ivens Filizola Soares Machado, Maria Paula Lopes Ponte Prado, Renato Bruno Cavalcante Leite, Samuel Magalhães Gurgel, José Walter Feitosa Gomes, José Huygens Parente Garcia","doi":"10.1590/0102-672020230066e1784","DOIUrl":"10.1590/0102-672020230066e1784","url":null,"abstract":"<p><strong>Background: </strong>Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients' symptoms. Peroral endoscopic myotomy (POEM) is an alternative endoscopic surgery to Heller cardiomyotomy, in which the procedure is performed orally, by endoscopy, offering efficacy comparable to surgical myotomy, with relative ease and minimal invasion, without external incisions.</p><p><strong>Aims: </strong>To study the safety of POEM by analyzing its results, adverse events and perioperative complications and the main ways to overcome them, in addition to evaluating the effectiveness of the procedure and the short-term postoperative quality of life.</p><p><strong>Methods: </strong>A qualitative and quantitative, observational and cross-sectional study that analyzed patients who underwent the POEM in a reference center, from December 2016 to December 2022, maintaining the technical standard of pre-, peri- and postoperative protocol.</p><p><strong>Results: </strong>A total of 94 patients were included in the study, and only three had postoperative complications. The average early postoperative Eckardt score was 0.93 and the late 1.40, with a mean improvement of 7.1 in early results and 6.63 in late results (p<0.05).</p><p><strong>Conclusions: </strong>POEM can be reproduced with an excellent safety profile, significant relief of symptoms and improvement in esophageal emptying, and in quality of life.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1784"},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PARTIAL HEPATECTOMY USING LINEAR CUTTER STAPLER: ARE THERE ADVANTAGES? 使用线性切割订书机进行肝部分切除术:有优势吗?
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-12-08 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230057e1775
Marcio Fernandes Chedid, Pietro Waltrick Brum, Tomaz de Jesus Maria Grezzana-Filho, Rafaela Kathrine da Silva, Pedro Funari Pereira, Aljamir Duarte Chedid, Cleber Rosito Pinto Kruel
{"title":"PARTIAL HEPATECTOMY USING LINEAR CUTTER STAPLER: ARE THERE ADVANTAGES?","authors":"Marcio Fernandes Chedid, Pietro Waltrick Brum, Tomaz de Jesus Maria Grezzana-Filho, Rafaela Kathrine da Silva, Pedro Funari Pereira, Aljamir Duarte Chedid, Cleber Rosito Pinto Kruel","doi":"10.1590/0102-672020230057e1775","DOIUrl":"https://doi.org/10.1590/0102-672020230057e1775","url":null,"abstract":"<p><strong>Background: </strong>Morbidity of liver resections is related to intraoperative bleeding and postoperative biliary fistulas. The Endo-GIA stapler (EG) in liver resections is well established, but its cost is high, limiting its use. The linear cutting stapler (LCS) is a lower cost device.</p><p><strong>Aims: </strong>To report open liver resections, using LCS for transection of the liver parenchyma and en bloc stapling of vessels and bile ducts.</p><p><strong>Methods: </strong>Ten patients were included in the study. Four patients with severe abdominal pain had benign liver tumors (three adenomas and one focal nodular hyperplasia). Among the remaining six patients, four underwent liver resection for the treatment of colorectal liver metastases, three of which had undergone preoperative chemotherapy. The other two cases were one patient with metastasis from a testicular teratoma and the other with metastasis from a gastrointestinal neuroectodermal tumor.</p><p><strong>Results: </strong>The average length of stay was five days (range 4-7 days). Of the seven patients who underwent resections of segments II/III, two presented postoperative complications: one developed a seroma and the other a collection of abdominal fluid who underwent percutaneous drainage, antibiotic therapy, and blood transfusion. Furthermore, the three patients who underwent major resections had postoperative complications: two developed anemia and received blood transfusions and one had biloma and underwent percutaneous drainage and antibiotic therapy.</p><p><strong>Conclusions: </strong>The use of the linear stapler in hepatectomies was efficient and at lower costs, making it suitable for use whenever EG is not available. The size of the LCS stapler shaft is more suitable for en bloc transection of the left lateral segment of the liver, which is thinner than the right one. Further studies are needed to evaluate the safety of LCS for large liver resections and resections of tumors located in the right hepatic lobe.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1775"},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ACUTE ABDOMEN IN INTENSIVE CARE UNIT: ETIOLOGY, COMORBIDITY AND SEVERITY OF 1,523 PATIENTS. 重症监护室急腹症:1523 名患者的病因、并发症和严重程度。
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-12-08 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230060e1778
Geraldo Fernandes de Almeida Filho, Pedro Paulo Costa E Silva, Murilo Tavares Valverde Filho, Maria Clara Alves Morais, Paulo Bravo de Oliveira Chagas, Ricardo Azevedo Cruz D'Oliveira, Liana Codes, Paulo Lisboa Bittencourt
{"title":"ACUTE ABDOMEN IN INTENSIVE CARE UNIT: ETIOLOGY, COMORBIDITY AND SEVERITY OF 1,523 PATIENTS.","authors":"Geraldo Fernandes de Almeida Filho, Pedro Paulo Costa E Silva, Murilo Tavares Valverde Filho, Maria Clara Alves Morais, Paulo Bravo de Oliveira Chagas, Ricardo Azevedo Cruz D'Oliveira, Liana Codes, Paulo Lisboa Bittencourt","doi":"10.1590/0102-672020230060e1778","DOIUrl":"https://doi.org/10.1590/0102-672020230060e1778","url":null,"abstract":"<p><strong>Background: </strong>Clinical features and outcomes of patients admitted to the intensive care unit due to acute abdomen are important to be investigated.</p><p><strong>Aims: </strong>To evaluate the outcomes of critically ill subjects with acute abdomen according to etiology, comorbidity and severity.</p><p><strong>Methods: </strong>Outcomes of 1,523 patients (878 women, mean age 66±18 years) consecutively admitted to a specialized gastrointestinal intensive care unit with different causes of acute abdomen from January 2012 to December 2019, were retrospectively evaluated according to etiology, comorbidity and severity.</p><p><strong>Results: </strong>The most common causes of acute abdomen were obstructive and inflammatory, particularly large bowel obstruction (27%), small bowel obstruction (18%) and acute pancreatitis (17%). Overall mortality was 13%. Surgery was required in 34% of patients. Median length of stay in the hospital was 9 [1-101] days. On univariate analysis mortality was significantly associated with age, APACHE II, Charlson comorbidity index, requirement for surgery and malignancy (p<0.0001), but only APACHE II, Charlson comorbidity index and surgical interventional remained significant on multivariate analysis.</p><p><strong>Conclusions: </strong>Critically ill patients admitted to the intensive care unit with acute abdomen constitute a heterogeneous group of subjects with different prognosis. Mortality is more related to the severity of the disease, comorbidity and need for surgery than to the etiology of the acute abdomen.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1778"},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
THE WATER-SOLUBLE CONTRAST FOR ADHESIVE SMALL BOWEL OBSTRUCTION: ARE THERE ADVANTAGES? 水溶性造影剂治疗粘连性小肠梗阻:有优势吗?
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-12-08 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230059e1777
Vinicius VON-Diemen, Bernardo Silveira Volkweis, Eduardo Ferreira Martins, Lara Luz de Miranda Silva, Leandro Totti Cavazzola
{"title":"THE WATER-SOLUBLE CONTRAST FOR ADHESIVE SMALL BOWEL OBSTRUCTION: ARE THERE ADVANTAGES?","authors":"Vinicius VON-Diemen, Bernardo Silveira Volkweis, Eduardo Ferreira Martins, Lara Luz de Miranda Silva, Leandro Totti Cavazzola","doi":"10.1590/0102-672020230059e1777","DOIUrl":"https://doi.org/10.1590/0102-672020230059e1777","url":null,"abstract":"<p><strong>Background: </strong>Adhesive small bowel obstruction is one of the most common causes of surgical emergencies, representing about 15% of hospital admissions. Defining the need and timing of surgical intervention still remains a challenge.</p><p><strong>Aims: </strong>To report the experience of using meglumine-based water-soluble contrast in a tertiary hospital in southern Brazil, comparing with the world literature.</p><p><strong>Methods: </strong>Patients suspected of having adhesive small bowel obstruction, according to their clinical conditions, underwent an established protocol, consisting of the administration of water-soluble contrast, followed by plain abdominal radiograph within 12 hours and by a new clinical evaluation. The protocol was initiated after starting conservative management, including fasting and placement of a nasogastric tube, as well as intravenous fluid reposition.</p><p><strong>Results: </strong>A total of 126 patients were submitted to the protocol. The water-soluble contrast test sensitivity and specificity after the first radiograph were 94.6 and 91.0%, respectively; after the second radiograph, these values were 92.3 and 100%. The general test values for sensitivity and specificity were 91.9 and 100%, respectively.</p><p><strong>Conclusions: </strong>The measure parameters evaluated in this study were similar to those found in the literature, contributing to endorse the importance of this test in the evaluation of patients with adhesive small bowel obstruction. The particular relevance of this study was the similar results that were found using a different type of meglumine-based contrast, which is available in Brazil.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1777"},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MANAGEMENT OF SYMPTOMS RECURRENCE AFTER MYOTOMY FOR ACHALASIA. A PRACTICAL APPROACH. 贲门失弛缓症肌切开术后症状复发的处理。实用方法。
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-12-08 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230062e1780
Francisco Tustumi, Sérgio Szachnowicz, Nelson Adami Andreollo, Francisco Carlos Bernal da Costa Seguro, Edno Tales Bianchi, André Fonseca Duarte, Ary Nasi, Rubens Antonio Aissar Sallum
{"title":"MANAGEMENT OF SYMPTOMS RECURRENCE AFTER MYOTOMY FOR ACHALASIA. A PRACTICAL APPROACH.","authors":"Francisco Tustumi, Sérgio Szachnowicz, Nelson Adami Andreollo, Francisco Carlos Bernal da Costa Seguro, Edno Tales Bianchi, André Fonseca Duarte, Ary Nasi, Rubens Antonio Aissar Sallum","doi":"10.1590/0102-672020230062e1780","DOIUrl":"10.1590/0102-672020230062e1780","url":null,"abstract":"<p><strong>Background: </strong>Achalasia is an esophageal motility disorder, and myotomy is one of the most used treatment techniques. However, symptom persistence or recurrence occurs in 9 to 20% of cases.</p><p><strong>Aims: </strong>This study aims to provide a practical approach for managing the recurrence or persistence of achalasia symptoms after myotomy.</p><p><strong>Methods: </strong>A critical review was performed to gather evidence for a rational approach for managing the recurrence or persistence of achalasia symptoms after myotomy.</p><p><strong>Results: </strong>To properly manage an achalasia patient with significant symptoms after myotomy, such as dysphagia, regurgitation, thoracic pain, and weight loss, it is necessary to classify symptoms, stratify severity, perform appropriate tests, and define a treatment strategy. A systematic differential diagnosis workup is essential to cover the main etiologies of symptoms recurrence or persistence after myotomy. Upper digestive endoscopy and dynamic digital radiography are the main tests that can be applied for investigation. The treatment options include endoscopic dilation, peroral endoscopic myotomy, redo surgery, and esophagectomy, and the decision should be based on the patient's individual characteristics.</p><p><strong>Conclusions: </strong>A good clinical evaluation and the use of proper tests jointly with a rational assessment, are essential for the management of symptoms recurrence or persistence after achalasia myotomy.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1780"},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ROBOTIC ASSISTED VERSUS LAPAROSCOPIC DISTAL PANCREATECTOMY: A RETROSPECTIVE STUDY. 机器人辅助与腹腔镜远端胰腺切除术:一项回顾性研究。
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-12-08 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230065e1783
Ricardo Jureidini, Guilherme Naccache Namur, Thiago Costa Ribeiro, Telesforo Bacchella, Lucas Stolzemburg, José Jukemura, Ulysses Ribeiro Junior, Ivan Cecconello
{"title":"ROBOTIC ASSISTED VERSUS LAPAROSCOPIC DISTAL PANCREATECTOMY: A RETROSPECTIVE STUDY.","authors":"Ricardo Jureidini, Guilherme Naccache Namur, Thiago Costa Ribeiro, Telesforo Bacchella, Lucas Stolzemburg, José Jukemura, Ulysses Ribeiro Junior, Ivan Cecconello","doi":"10.1590/0102-672020230065e1783","DOIUrl":"https://doi.org/10.1590/0102-672020230065e1783","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive distal pancreatectomy (MIDP) is associated with less blood loss and faster functional recovery. However, the benefits of robotic assisted distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP) are unknown.</p><p><strong>Aims: </strong>To compare RDP versus LDP for surgical treatment of benign lesions, pre-malignant and borderline malignant pancreatic neoplasias.</p><p><strong>Methods: </strong>This is a retrospective study comparing LDP with RDP. Main outcomes were overall morbidity and overall costs. Secondary outcomes were pancreatic fistula (PF), infectious complications, readmission, operative time (OT) and length of hospital stay (LOS).</p><p><strong>Results: </strong>Thirty patients submitted to LDP and 29 submitted to RDP were included in the study. There was no difference regarding preoperative characteristics. There was no difference regarding overall complications (RDP - 72,4% versus LDP - 80%, p=0,49). Costs were superior for patients submitted to RDP (RDP=US$ 6,688 versus LDP=US$ 6,149, p=0,02), mostly due to higher costs of surgical materials (RDP=US$ 2,364 versus LDP=1,421, p=0,00005). Twenty-one patients submitted to RDP and 24 to LDP developed pancreatic fistula (PF), but only 4 RDP and 7 LDP experienced infectious complications associated with PF. OT (RDP=224 min. versus LDP=213 min., p=0.36) was similar, as well as conversion to open procedure (1 RDP and 2 LDP).</p><p><strong>Conclusions: </strong>The postoperative morbidity of robotic distal pancreatectomy is comparable to laparoscopic distal pancreatectomy. However, the costs of robotic distal pancreatectomy are slightly higher.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1783"},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
SALVAGE ALPPS PROCEDURE FOR FAILED PORTAL VEIN EMBOLIZATION. 门静脉栓塞失败的抢救alpps手术。
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-12-04 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230058e1776
João Victor Vecchi Ferri, Flávia Heinz Feier, Leandro Armani Scaffaro, Leticia Maffazioli, Celina Pereira Hallal, Cleber Rosito Pinto Kruel, Marcio Fernandes Chedid, Tomaz de Jesus Maria Grezzana Filho
{"title":"SALVAGE ALPPS PROCEDURE FOR FAILED PORTAL VEIN EMBOLIZATION.","authors":"João Victor Vecchi Ferri, Flávia Heinz Feier, Leandro Armani Scaffaro, Leticia Maffazioli, Celina Pereira Hallal, Cleber Rosito Pinto Kruel, Marcio Fernandes Chedid, Tomaz de Jesus Maria Grezzana Filho","doi":"10.1590/0102-672020230058e1776","DOIUrl":"10.1590/0102-672020230058e1776","url":null,"abstract":"","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1776"},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COLORECTAL CANCER: HISTOPATHOLOGICAL PROFILE AND PREVALENCE OF DNA REPAIR SYSTEM DEFICIENCY IN PATIENTS SUBMITTED TO SURGICAL TREATMENT IN A UNIVERSITY HOSPITAL. 结直肠癌:在一所大学医院接受手术治疗的患者中,组织病理学特征和DNA修复系统缺陷的患病率。
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-10-23 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230053e1771
Julia Werner de Oliveira, Raquel Aguirra de Moraes, Samya Hamad Mehanna, Julia Costa Linhares
{"title":"COLORECTAL CANCER: HISTOPATHOLOGICAL PROFILE AND PREVALENCE OF DNA REPAIR SYSTEM DEFICIENCY IN PATIENTS SUBMITTED TO SURGICAL TREATMENT IN A UNIVERSITY HOSPITAL.","authors":"Julia Werner de Oliveira,&nbsp;Raquel Aguirra de Moraes,&nbsp;Samya Hamad Mehanna,&nbsp;Julia Costa Linhares","doi":"10.1590/0102-672020230053e1771","DOIUrl":"10.1590/0102-672020230053e1771","url":null,"abstract":"<p><strong>Background: </strong>Part of colorectal cancer cases occurs due to modifications in the DNA mismatch repair system, which are responsible for microsatellite instability. This alteration results in an unconventional phenotypic pattern of colorectal cancer.</p><p><strong>Aims: </strong>To describe the epidemiological, histopathological and molecular profiles of patients with colorectal cancer who underwent surgical treatment in a reference hospital.</p><p><strong>Methods: </strong>This is a cross-sectional, retrospective study with a quantitative approach, that included a review of patients' medical records who underwent oncological surgery for colorectal cancer.</p><p><strong>Results: </strong>A total of 122 colorectal cancer cases were identified, with microsatellite instability detected in 8.2% of the sample. The gender distribution was similar, with 52.46% males, and the weighted average age was 63 years (standard deviation±11.65). However, in the microsatellite instability group, the predominant age was below 60 years. Regarding the histological type, adenocarcinoma not otherwise specified accounted for 80.33% of the cases, being the most prevalent in both groups, with the mucinous type being more frequent among the instability cases. The pT3 pathological staging (46.72%) was the most predominant. The topography was more prevalent on the left (60.66%), but there was a significant difference when compared to the group with microsatellite instability, in which 80% of the neoplasms were located on the right (p=0.006).</p><p><strong>Conclusions: </strong>Differences in age and neoplastic topography found in microsatellite instability samples highlight the distinctive presentation pattern of the disease. Recognizing these characteristics is essential for developing prevention strategies, in addition to early and accurate diagnosis of colorectal cancer.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1771"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10595073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY. 生物治疗时代急性结肠炎术后早期并发症的危险因素。
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-10-23 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230052e1770
Lucas Faraco Sobrado, Fernando Noboru Cabral Mori, Carolina Bortolozzo Graciolli Facanali, Mariane Gouvea Monteiro Camargo, Sérgio Carlos Nahas, Carlos Walter Sobrado
{"title":"RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY.","authors":"Lucas Faraco Sobrado,&nbsp;Fernando Noboru Cabral Mori,&nbsp;Carolina Bortolozzo Graciolli Facanali,&nbsp;Mariane Gouvea Monteiro Camargo,&nbsp;Sérgio Carlos Nahas,&nbsp;Carlos Walter Sobrado","doi":"10.1590/0102-672020230052e1770","DOIUrl":"10.1590/0102-672020230052e1770","url":null,"abstract":"<p><strong>Background: </strong>Despite major advances in the clinical treatment of inflammatory bowel disease, some patients still present with acute colitis and require emergency surgery.</p><p><strong>Aims: </strong>To evaluate the risk factors for early postoperative complications in patients undergoing surgery for acute colitis in the era of biologic therapy.</p><p><strong>Methods: </strong>Patients with inflammatory bowel disease admitted for acute colitis who underwent total colectomy at a single tertiary hospital from 2012 to 2022 were evaluated. Postoperative complications were graded according to Clavien-Dindo classification (CDC). Patients with more severe complications (CDC≥2) were compared with those with less severe complications (CDC<2).</p><p><strong>Results: </strong>A total of 46 patients underwent surgery. The indications were: failure of clinical treatment (n=34), patients' or surgeon's preference (n=5), hemorrhage (n=3), toxic megacolon (n=2), and bowel perforation (n=2). There were eight reoperations, 60.9% of postoperative complications classified as CDC≥2, and three deaths. In univariate analyses, preoperative antibiotics use, ulcerative colitis diagnosis, lower albumin levels at admission, and preoperative hospital stay longer than seven days were associated with more severe postoperative complications.</p><p><strong>Conclusions: </strong>Emergency surgery for acute colitis was associated with a high incidence of postoperative complications. Preoperative use of antibiotics, ulcerative colitis, lower albumin levels at admission, and delaying surgery for more than seven days were associated with more severe early postoperative complications. The use of biologics was not associated with worse outcomes.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"36 ","pages":"e1770"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10595074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PROFESSOR PAULO ROBERTO SAVASSI ROCHA - FORMER PRESIDENT OF THE BRAZILIAN COLLEGE OF DIGESTIVE SURGERY. 巴西消化外科学院前院长paoloroberto-savasi-ROCHA教授。
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery Pub Date : 2023-10-13 eCollection Date: 2023-01-01 DOI: 10.1590/0102-672020230044e1762
Samir Rasslan
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引用次数: 0
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